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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/4099

Title: Effectiveness of adalimumab for rheumatoid arthritis in patients with a history of TNF-antagonist therapy in clinical practice
Authors: Bombardieri, S.
Ruiz, A. A.
Fardellone, P.
McKenna, F.
Unnebrink, K.
Oezer, U.
Kary, S.
Kupper, H.
Burmester, G. R.
Issue Date: 2007
Citation: RHEUMATOLOGY, 46(7). p. 1191-1199
Abstract: Objective. To evaluate the effectiveness and safety of adalimumab in patients with rheumatoid arthritis (RA) who previously discontinued tumour necrosis factor (TNF) antagonists for any reason in clinical practice. Methods. ReAct (Research in Active Rheumatoid Arthritis) was a large, open-label trial that enrolled adults with active RA who had previously been treated with traditional disease-modifying anti-rheumatic drugs or biological response modifiers. Patients self-administered adalimumab 40 mg subcutaneously every other week for 12 weeks and were allowed to enter an optional long-term extension phase. Measures of adalimumab effectiveness included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) response criteria, Disease Activity Score 28 (DAS28) and the Health Assessment Questionnaire Disability Index (HAQ DI). Results. Of 6610 patients, 899 had a history of etanercept and/or infliximab therapy; these patients experienced substantial clinical benefit from adalimumab treatment. At week 12, 60% of patients had an ACR20 and 33% had an ACR50 response; 76% had a moderate and 23% had a good EULAR response. In addition, 12% achieved a DAS28 < 2.6, indicating clinical remission, and 13% achieved a HAQ DI score <0.5. The allergic adverse event rate, regardless of relationship to adalimumab, was 6.5/100-patient-years (PYs) in previously TNIF-antagonist-exposed patients and 4.3/100-PYs in TNIF-antagonist-naive patients. A multiple regression analysis indicated no statistically significantly increased risk of serious infections in patients who received prior TNF antagonists compared with TNF-antagonist-naive patients. Conclusion. In typical clinical practice, adalimumab was effective and well-tolerated in patients with RA previously treated with etanercept and/or infliximab.
Notes: Univ Pisa, Dept Internal Med, I-56126 Pisa, Italy. Hosp Cruces, Bilbao, Spain. CHU Amiens, Hop Nord, Amiens, France. Univ Hasselt, Diepenbeek, Belgium. Univ Hosp, Maastricht, Netherlands. Trafford Gen Hosp, Manchester, Lancs, England. Abbott GmbH & Co KG, Ludwigshafen, Germany. Univ Med Berlin, Charite, Berlin, Germany.Bombardieri, S, Univ Pisa, Dept Internal Med, Via Roma 67, I-56126 Pisa, Italy.s.bombardieri@int.med.unipi.it
URI: http://hdl.handle.net/1942/4099
DOI: 10.1093/rheumatology/kem091
ISI #: 000248450600031
ISSN: 1462-0324
Category: A1
Type: Journal Contribution
Validation: ecoom, 2008
Appears in Collections: Research publications

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