New biologic agents have changed the paradigm of rheumatoid arthritis treatment, leading to improvement in managing patients' refractory to classical DMARDs. Anti-TNF-alpha is used as first-line treatment in patients failing to respond to classical DMARDs. However, up to 50% of patients fail to respond to these drugs or develop adverse events leading to treatment discontinuation: in these cases the optimal treatment strategy is still a matter of debate even if trying with a second anti-TNF-alpha is considered a good option. We report data of patients switching from a first to a second anti-TNF-alpha from an Italian registry of patients with rheumatoid arthritis, showing that switching is valuable in patients stopping a first anti-TNF alpha drug. The patients with higher disease activity levels and those stopping the first anti-TNFa treatment because of a lack of efficacy are very likely to respond to the second treatment.

Switching TNF-alpha antagonists in rheumatoid arthritis: the experience of the LORHEN registry / R. Caporali, P. Sarzi-Puttini, F. Atzeni, R. Gorla, M. Filippini, A. Marchesoni, E. Favalli, F. Bobbio-Pallavicini, C. Montecucco. - In: AUTOIMMUNITY REVIEWS. - ISSN 1568-9972. - 9:6(2010), pp. 465-469.

Switching TNF-alpha antagonists in rheumatoid arthritis: the experience of the LORHEN registry

R. Caporali
Primo
;
P. Sarzi-Puttini;E. Favalli;
2010

Abstract

New biologic agents have changed the paradigm of rheumatoid arthritis treatment, leading to improvement in managing patients' refractory to classical DMARDs. Anti-TNF-alpha is used as first-line treatment in patients failing to respond to classical DMARDs. However, up to 50% of patients fail to respond to these drugs or develop adverse events leading to treatment discontinuation: in these cases the optimal treatment strategy is still a matter of debate even if trying with a second anti-TNF-alpha is considered a good option. We report data of patients switching from a first to a second anti-TNF-alpha from an Italian registry of patients with rheumatoid arthritis, showing that switching is valuable in patients stopping a first anti-TNF alpha drug. The patients with higher disease activity levels and those stopping the first anti-TNFa treatment because of a lack of efficacy are very likely to respond to the second treatment.
Rheumatoid arthritis; Anti-TNF-alpha; DMARDs; Methotrexate
Settore MED/16 - Reumatologia
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/664262
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