PT  - JOURNAL ARTICLE
AU  - MARLIES BLOM
AU  - WIETSKE KIEVIT
AU  - JAAP FRANSEN
AU  - INA H. KUPER
AU  - ALFONS A. den BROEDER
AU  - CARLA M.A. De GENDT
AU  - TIM L. JANSEN
AU  - HERMAN L.M. BRUS
AU  - MART A.F.J. van de LAAR
AU  - PIET L.C.M. van RIEL
TI  - The Reason for Discontinuation of the First Tumor Necrosis Factor (TNF) Blocking Agent Does Not Influence the Effect of a Second TNF Blocking Agent in Patients with Rheumatoid Arthritis
AID  - 10.3899/jrheum.090054
DP  - 2009 Oct 01
TA  - The Journal of Rheumatology
PG  - 2171--2177
VI  - 36
IP  - 10
4099  - http://www.jrheum.org/content/36/10/2171.short
4100  - http://www.jrheum.org/content/36/10/2171.full
SO  - J Rheumatol2009 Oct 01; 36
AB  - Objective. To investigate whether the reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent influences the effect of a second TNF blocking agent. Methods. Data were used from 2 Dutch registries including patients with rheumatoid arthritis (RA) treated with TNF blocking agents. Patients were divided into 3 groups based on reason for discontinuation of the first: nonresponse, loss of response, or adverse events. The primary outcome was the change from baseline of the disease activity (by DAS28) at 6 months, corrected for the baseline DAS28 score. Secondary outcomes were the change from baseline at 3 months, EULAR response rates, and the percentages of patients who reached a DAS28 score ≤ 3.2 at 3 and at 6 months. Results. In total, 49 patients who failed due to nonresponse, 75 due to loss of response, and 73 due to adverse events were included. At 6 months, the change of DAS28 score from baseline did not differ significantly between the groups (−0.6 to −1.3; p ≥ 0.173) and similar good and moderate response rates were found (12% to 18%, p ≥ 0.523, and 34% to 55%, p ≥ 0.078, respectively). The secondary outcomes were also comparable between the 3 groups. Conclusion. The results of our observational study suggest that a second TNF blocking agent may be effective after failure of the first, regardless of the reason for discontinuation of the first TNF blocking agent.