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Autoimmun Rev. 2009 Jan;8(3):260-5. doi: 10.1016/j.autrev.2008.11.001. Epub 2008 Nov 21.

Anti-TNFalpha therapy in a cohort of rheumatoid arthritis patients: clinical outcomes.

Author information

  • 1Rheumatology and Immunology Unit, Spedali Civili di Brescia, Brescia, Italy. bazzani@bresciareumatologia.it

Abstract

OBJECTIVE:

To assess the effectiveness of anti-TNFalpha agents by analysing the principal clinical outcomes in patients with active rheumatoid arthritis (RA).

METHODS:

1010 patients who received no clinical benefit from previous treatment with methotrexate and/or other DMARDs, were subsequently treated with one or more of the anti-TNFalpha agents.

RESULTS:

After the first six months of anti-TNFalpha therapy, 29% of the patients showed a good and 47% a moderate European League Against Rheumatism (EULAR) response, and this positive result was maintained after two years of follow-up. Their median Disease Activity Score based on the erythrocyte sedimentation rate and the evaluation of 28 joints (DAS28) decreased from 5.94 at baseline to 4 after six months (p<0.001; Delta 1.94), and further significant responses were also observed after 12, 18 and 24 months; their median 36-month DAS28 score reflected mild disease activity. The median Health Assessment Questionnaire (HAQ) score fell from 1.34 at baseline to 1 after six months of therapy (Delta 0.34; p<0.05), and a further significant reduction was observed during the second and third year of follow up.

CONCLUSIONS:

Especially when combined with DMARDs, anti-TNFalpha drugs can induce a good clinical response regardless of the particular molecule used, whereas their combination with steroids does not seem to improve disease outcomes at any time during follow-up.

PMID:
19027090
[PubMed - indexed for MEDLINE]
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