The Efficacy of Sequential Biologic Agents in Refractory Rheumatoid Arthritis after Failure of Initial DMARD and anti-Tumor Necrosis Factor Therapy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Drug-Specific Response Rates and Disease Activity-Group I
3.2. Drug-Specific Response Rates and Disease Activity-Group II
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Switch (Group I) | Second Switch (Group II) | |
---|---|---|
Age (y), (mean ± SD) | 54 ± 8.47 | 53 ± 7.93 |
BMI (Kg/m2), (mean ± SD) | 25.02 ± 4.04 | 25.14 ± 4.99 |
Female (%) | 89 (80) | 22 (82) |
Duration of disease (y), (mean ± SD) * | 13.37 ± 6.12 | 27 ± 7.56 |
DAS28, (mean ± SD) | 5.63 ± 1.30 | 5.33 ± 2.19 |
HAQ, (mean ± SD) | 2.07 ± 0.50 | 1.94 ± 0.67 |
Concurrent corticosteroid use | ||
None, n (%) | 22 (20) | 5 (19) |
≤5 mg, n (%) | 67 (60) | 15 (56) |
>5 mg, n (%) | 15 (18) | 6 (22) |
Concurrent MTX use, n (%) | 69 (62) | 16 (60) |
Weekly MTX dose (mg), (mean ± SD) | 8.80 ± 2.40 | 9.2 ± 2.20 |
Concurrent other DMARDs use, n (%) | 22 (20) | 6 (22) |
First Switch (Group I) | Second Switch (Group II) | |||
---|---|---|---|---|
6 Months | 12 Months | 6 Months | 12 Months | |
Tocilizumab (n = 24) | Tocilizumab (n = 6) | |||
No response, n (%) | 3 (12.5) | 0 (0) | 0 (0) | 0 (0) |
Moderate response, n (%) | 21 (87.5) | 6 (25) | 3 (50) | 3 (50) |
Good response, n (%) | 0 (0) | 18 (75) | 3 (50) | 3 (50) |
Abatacept (n = 24) | Abatacept (n = 9) | |||
No response, n (%) | 6 (25) | 0 (0) | 3 (33) | 0 (0) |
Moderate response, n (%) | 15 (62.5) | 18 (75) | 3 (33) | 9 (100) |
Good response, n (%) | 3 (12.5) | 6 (25) | 3 (33) | 0 (0) |
Adalimumab (n = 12) | Adalimumab (n = 3) | |||
No response, n (%) | 0 (0) | 0 (0) | 2 (66) | 0 (0) |
Moderate response, n (%) | 9 (75) | 6 (50) | 1 (33) | 3 (100) |
Good response, n (%) | 3 (25) | 6 (50) | 0 (0) | 0 (0) |
Etanercept (n = 33) | Etanercept (n = 9) | |||
No response, n (%) | 0 (0) | 0 (0) | 9 (100) | 0 (0) |
Moderate response, n (%) | 30 (91) | 6 (18) | 0 (0) | 6 (66) |
Good response, n (%) | 3 (9) | 27 (82) | 0 (0) | 3 (33) |
Infliximab (n = 15) | ||||
No response, n (%) | 0 (0) | 0 (0) | ||
Moderate response, n (%) | 15 (100) | 0 (0) | ||
Good response, n (%) | 0 (0) | 15 (100) |
Group I (n = 111) | Group II (n = 27) | |
---|---|---|
HAQ0 | 2.07 (0.51) | 1.94 (0.47) |
HAQ6 | 0.98 (0.37) * | 1.01 (0.46) * |
HAQ12 | 0.53 (0.18) * | 0.78 (0.37) * |
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Versace, A.G.; Aragona, C.O.; La Rosa, D.; Chiappalone, M.; Tringali, M.C.; De Gaetano, A.; Moore, C.F., Jr.; Sangari, D.; Roberts, W.N.; Bagnato, G. The Efficacy of Sequential Biologic Agents in Refractory Rheumatoid Arthritis after Failure of Initial DMARD and anti-Tumor Necrosis Factor Therapy. Rheumato 2021, 1, 22-30. https://doi.org/10.3390/rheumato1010005
Versace AG, Aragona CO, La Rosa D, Chiappalone M, Tringali MC, De Gaetano A, Moore CF Jr., Sangari D, Roberts WN, Bagnato G. The Efficacy of Sequential Biologic Agents in Refractory Rheumatoid Arthritis after Failure of Initial DMARD and anti-Tumor Necrosis Factor Therapy. Rheumato. 2021; 1(1):22-30. https://doi.org/10.3390/rheumato1010005
Chicago/Turabian StyleVersace, Antonio Giovanni, Caterina Oriana Aragona, Daniela La Rosa, Marianna Chiappalone, Maria Concetta Tringali, Alberta De Gaetano, Charles Frederick Moore, Jr., Donatella Sangari, William Neal Roberts, and Gianluca Bagnato. 2021. "The Efficacy of Sequential Biologic Agents in Refractory Rheumatoid Arthritis after Failure of Initial DMARD and anti-Tumor Necrosis Factor Therapy" Rheumato 1, no. 1: 22-30. https://doi.org/10.3390/rheumato1010005