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Báo cáo y học: "Effectiveness and safety of adalimumab in patients with ankylosing spondylitis or psoriatic arthritis and history of anti-tumor necrosis factor therapy"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Effectiveness and safety of adalimumab in patients with ankylosing spondylitis or psoriatic arthritis and history of anti-tumor necrosis factor therapy. | Rudwaleit et al. Arthritis Research Therapy 2010 12 R117 http arthritis-research.eom content 12 3 R117 RESEARCH ARTICLE Open Access EffeCCtiveness and safety of adalimumab in patients with ankylosing spondylitis or psoriatic arthritis and history of anti-tumor necrosis factor therapy Martin Rudwaleit 1 Filip Van den Bosch2 Martina Kron3 Sonja Kary3 and Hartmut Kupper3 Abstract Introduction Tumor necrosis factor TNF antagonists reduce the signs and symptoms of spondyloarthritides including ankylosing spondylitis AS and psoriatic arthritis PsA . Our objective was to evaluate the effectiveness and safety of adalimumab 40 mg every other week for patients with AS or PsA and prior treatment with infliximab IFX and or etanercept ETN . Methods Both trials were 12-week open-label studies with an optional extension period up to week 20. Patients were stratified by history of anti-TNF treatment prior anti-TNF therapy received IFX ETN or both and reason for discontinuation of prior TNF antagonist. ETN was discontinued 3 weeks and IFX was discontinued 2 months before the first adalimumab administration. Effectiveness at week 12 was evaluated by using observed standard-outcome measurements for AS and PsA. Results At week 12 of adalimumab treatment Bath Ankylosing Spondylitis Disease Activity Index 50 responses were achieved by 40.8 of 326 patients with AS who had received prior anti-TNF therapy and by 63.0 of 924 patients with AS who were naive to TNF antagonist. Observed response rates were generally greater for patients who discontinued the prior anti-TNF therapy because of loss of response or intolerance than for patients who discontinued because of lack of response. Median changes in swollen-joint count and in enthesitis score were similar in patients with and without prior TNF-antagonist treatment. Modified PsA response criteria were fulfilled by 71.2 of 66 patients with PsA with prior exposure to TNF antagonists and by 78.8 of 376 patients with no history of anti-TNF .