RT Journal Article
T1 DAS-28-based EULAR response and HAQ improvement in rheumatoid arthritis patients switching between TNF antagonists
A1 Navarro Sarabia, Federico
A1 Ruiz Montesinos, Dolores
A1 Hernández, Blanca
A1 Navarro Compán, Victoria
A1 Marsal, Sara
A1 Barcelo, Mireia
A1 Pérez Pampín, Eva
A1 Gómez-Reino Carnota, Juan Jesús
K1 Rheumatoid Arthritis Patient
K1 Herpes Zoster
K1 Retention Rate
K1 Tocilizumab
K1 Abatacept
AB IntroductionNo definitive data are available regarding the value of switching to an alternative TNF antagonist in rheumatoid arthritis patients who fail to respond to the first one. The aim of this study was to evaluate treatment response in a clinical setting based on HAQ improvement and EULAR response criteria in RA patients who were switched to a second or a third TNF antagonist due to failure with the first one.MethodsThis was an observational, prospective study of a cohort of 417 RA patients treated with TNF antagonists in three university hospitals in Spain between January 1999 and December 2005. A database was created at the participating centres, with well-defined operational instructions. The main outcome variables were analyzed using parametric or non-parametric tests depending on the level of measurement and distribution of each variable.ResultsMean (± SD) DAS-28 on starting the first, second and third TNF antagonist was 5.9 (± 2.0), 5.1 (± 1.5) and 6.1 (± 1.1). At the end of follow-up, it decreased to 3.3 (± 1.6; Δ = -2.6; p > 0.0001), 4.2 (± 1.5; Δ = -1.1; p = 0.0001) and 5.4 (± 1.7; Δ = -0.7; p = 0.06). For the first TNF antagonist, DAS-28-based EULAR response level was good in 42% and moderate in 33% of patients. The second TNF antagonist yielded a good response in 20% and no response in 53% of patients, while the third one yielded a good response in 28% and no response in 72%. Mean baseline HAQ on starting the first, second and third TNF antagonist was 1.61, 1.52 and 1.87, respectively. At the end of follow-up, it decreased to 1.12 (Δ = -0.49; p < 0.0001), 1.31 (Δ = -0.21, p = 0.004) and 1.75 (Δ = -0.12; p = 0.1), respectively. Sixty four percent of patients had a clinically important improvement in HAQ (defined as ≥ -0.22) with the first TNF antagonist and 46% with the second.ConclusionA clinically significant effect size was seen in less than half of RA patients cycling to a second TNF antagonist
PB BMC
YR 2009
FD 2009
LK http://hdl.handle.net/10347/22952
UL http://hdl.handle.net/10347/22952
LA eng
NO Navarro-Sarabia, F., Ruiz-Montesinos, D., Hernandez, B. et al. DAS-28-based EULAR response and HAQ improvement in rheumatoid arthritis patients switching between TNF antagonists. BMC Musculoskelet Disord 10, 91 (2009)
NO The study was partially funded by a grant of BMS, Spain, and by RETICS Program, RD08/0075 (RIER) from the Instituto de Salud Carlos III (ISCIII), within the VI PN de I+D+I 2008–2011
DS Minerva
RD 23 abr 2026