RT Journal Article
SR Electronic
T1 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
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.090054
DO 10.3899/jrheum.090054
A1 Marlies Blom
A1 Wietske Kievit
A1 Jaap Fransen
A1 Ina H. Kuper
A1 Alfons A. den Broeder
A1 Carla M.A. De Gendt
A1 Tim L. Jansen
A1 Herman L.M. Brus
A1 Mart A.F.J. van de Laar
A1 Piet L.C.M. van Riel
YR 2009
UL http://www.jrheum.org/content/early/2009/08/29/jrheum.090054.abstract
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.