Document Detail


Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR Study.
MedLine Citation:
PMID:  22736086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effectiveness of switching to rituximab (RTX) with switching to alternative tumour necrosis factor (TNF) antagonists in patients with rheumatoid arthritis (RA) failing on TNF antagonists.
METHODS: A multicentre prospective 3-year observational study was performed in patients with RA treated with RTX or an alternative TNF antagonist. The baseline 28-joint disease activity score (DAS28) and Health Assessment Questionnaire (HAQ) score were compared with 6, 9 and 12 month values, adjusting for propensity score quintiles. Propensity scores were estimated for each patient using logistic regression with treatment as the dependent variable and baseline prior number of TNFs >1, years from diagnosis >5, extra-articular manifestations, previous toxicity, use of ≥2 disease-modifying antirheumatic drugs, age and sex as independent variables.
RESULTS: 1124 patients were treated with either RTX (n=591, 52.6%) or alternative TNF antagonists (n=533, 47.4%). RTX-treated patients had longer disease duration (p=0.0001), larger numbers of previous TNF antagonists (p<0.0001) and tender and swollen joints (p<0.0001). There was no significant difference in the reduction in DAS28 at 6, 9 and 12 months between RTX-treated patients and those treated with TNF antagonists. However, the reduction in DAS28 was significantly different between RTX-treated patients and adalimumab/infliximab-treated patients (p=0.001 and p=0.05, respectively). There was a marginally significant difference at any time period in the proportion of patients achieving an improvement in the HAQ score of >0.22 (p=0.06).
CONCLUSIONS: Optimal treatment for patients with RA failing on treatment with TNF antagonists may include RTX. This study suggests that the improvement in DAS28 is larger in patients treated with RTX than in those treated with monoclonal anti-TNF agents.
Authors:
Juan J Gomez-Reino; Jose Ramon Maneiro; Jorge Ruiz; Rosa Roselló; Raimon Sanmarti; Ana Belen Romero;
Related Documents :
674866 - Indirect assessment of lung compliance in chronic lung diseases.
2707796 - Surgical pathology of the lung in anti-basement membrane antibody-associated goodpastur...
18932026 - Characteristics of lung cancer patients with asbestos-related radiological findings.
2393316 - Clubbing in hypersensitivity pneumonitis. its prevalence and possible prognostic role.
22050666 - Managing acute respiratory decompensation in the morbidly obese.
23333776 - Molecular monitoring of bcr-abl transcripts after allogeneic stem cell transplantation ...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-06-26
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  71     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-08     Completed Date:  2012-12-20     Revised Date:  2014-01-02    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1861-4     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal, Murine-Derived / therapeutic use*
Antirheumatic Agents / classification,  therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  pathology,  physiopathology
Drug Substitution*
Female
Health Status
Humans
Joints / drug effects,  pathology,  physiopathology
Male
Middle Aged
Propensity Score
Prospective Studies
Severity of Illness Index
Survival Rate
Treatment Failure
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/Antirheumatic Agents; 0/Tumor Necrosis Factor-alpha; 0/rituximab
Investigator
Investigator/Affiliation:
Alicia García / ; Juan Povedano / ; Paula Cejas / ; Federico Navarro / ; José Alejandro Ariza Ariza / ; Silvia Ricca / ; Juan Sánchez Bursón / ; Wenceslao Herranz Mediano / ; Manuel A Guzmán Ubeda / ; Purificación Salas Blanca / ; Enrique Raya / ; Pilar Morales Garrido / ; Amalia Rueda / ; Manuel Romero / ; Antonio Fernández / ; Ángeles Belmonte / ; Rosa García / ; Adela Ruíz / ; José J Pérez Venegas / ; José Salberii / ; Raúl Menor / ; Yolanda Grandal / ; Manuel Paez-Camin / ; Ma del Mar Ruiz / ; Dolores Mendoza / ; Manuel Riesco / ; Celia Fernández / ; Concepción Delgado / ; Rosa Roselló / ; Pina / ; Dolores Fabregas / ; Juan Carlos Torre Alonso / ; Francisco Javier Ballina García / ; Mercedes Algeri López / ; Rubén Queiro Silva / ; José Luis Riertra Noriega / ; Luis Arboleya / ; Tomás Tinturé / ; Luis Espadaler Poch / ; Jordi Fiter Areste / ; Inmaculada Ros Vilamajó / ; Antonio Juan Mai / ; Teresa Font / ; Miguel Pericas Alemany / ; Ana Urruticoechea Arana / ; Sagrario Bustabad / ; Ivan Ferraz / ; Alberto Cantabrana / ; Daniel Batista / ; J Angel Hdez / ; Juan Carlos Quevedo / ; Íñigo Rúa-Figueroa / ; Jaime Calvo / ; Elena Arrecoechea / ; Teresa Jimeno / ; Raimon Sanmarti / ; M Victoria Hernández / ; Carme Moragues / ; Ingrid Möller / ; Nishishinya Ma Batina / ; Díaz Torné / ; Vicente Torrente Segarra / ; Asunción Acosta / ; Ma Bonet / ; Eduardo Kanterewicz / ; José Rodriguez / ; Ramón Figuls / ; Marta Larrosa Padró / ; Antonio Gómez / ; José Valverde García / ; Elena Sirvent / ; Delia Reina Sanz / ; Jose Miguel Ruiz / ; Sergio Ros / ; Jordi del Blanco / ; Joan Maymó / ; Mapi Lisbona / ; Carolina Pérez / ; Miriam Almirall / ; Núria Aizpunua Perez / ; Silvia Sánchez / ; Alejandro Olivé / ; Elisa Garcia / ; Georgina Salvador / ; Elena Riera / ; Marsal / ; Maria Isabel Rotés / ; Estefania Moreno / ; Teresa Claveguera / ; Ramón Valls / ; Miquel Sala / ; Marta Valls / ; Lluis Roselló / ; Sergi Ordoñez Palau / ; Silvia Paredes / ; Josep Pujol / ; Rosa Morlà / ; Ramon Fontova Garrofí / ; Ma José Poveda Elias / ; X Arasa / ; Alfons Lorenzo Querol / ; Ma José Poveda Elias / ; Enrique Judez / ; Gloria Garcia / ; Paula Virginia / ; Julio Vázquez / ; Pilar Muñoz / ; Juana Sampedro Álvarez / ; Angel M García Aparicio / ; Azucena Hernández Sanz / ; Jose Rey Rey / ; Montserrat Corteguera / ; Manuel Martín Martínez / ; Lucia Pantoja / ; Montilla / ; Purificación Ruiz / ; J M Martín Santos / ; Jose Luis Alvarez Vega / ; Jose Maria Salazar / ; Eugenio Chamizo / ; Juan Jose Aznar / ; Noemí Garrido / ; Antonio Cardenal Escarcena / ; Antonia Ferreira Conejo / ; Raúl Veroz González / ; José García Toron / ; Miguel Ángel Abad / ; María Torresano Andrés / ; Mercedes Freire / ; Jenaro Graña / ; Marina Rodriguez López / ; Ma Ángeles Hernández / ; Jorge Blanco Rodríguez / ; Juan José Díaz Garel / ; Manuel Rodríguez Fernández / ; Luis Fernández Domínguez / ; Alfredo Willisch Domínguez / ; Juan Cruz Martinez / ; Rubén Ouviña / ; Iñigo Hernández / ; Ceferino Barbazán / ; José Ángel Cabezas / ; Julio Gracia Estevez / ; Mateo / ; Beatriz Joven / ; María Galindo / ; Luis Morillas / ; Pilar Fernández Dapica / ; Laura González Hombrados / ; Padrino Herrera / ; Javier García / ; María Alcalde / ; Esperanza Naredo / ; Collado Paz / ; Luis Carreño / ; Marilyn Salvat / ; Indalecio Monteagudo / ; Crespo / ; Gonzalez / ; Francisco Javier López / ; Esther Vicente Rabaneda / ; Esther Coledaro / ; Sánchez Atrio / ; Tatiana Cobo / ; Martina Steiner / ; Paloma de Abreu / ; Oscar Illera / ; Roberto Mígueles Sánchez / ; Ma Cruz Fdez Espartero / ; Virginia Villaverde García / ; Mercedes Morcillo Valle / ; Jacqueline Usón Jaefer / ; Pedro Zarco / ; Prada / ; Mulero / ; María Luisa González / ; Ángel Aragón / ; Carlos Rodríguez Escalera / ; Francisco García Villalba / ; Manuel Moreno Ramos / ; Juan Moreno Morales / ; Carmelo Tornero / ; Encarnación Saiz Cuenca / ; Carlos Marras / ; Nuria Lozano / ; Emilia Aznar / ; Reina Sofía / ; Eduardo Loza Cortina / ; Concepción Fito / ; Natividad del Val / ; Rosario Ibañez / ; Ricardo Gutierrez / ; Juan Carlos Vesga / ; Alberto Alonso Ruiz / ; José Miguel Aramburu Albizuri / ; M Luz García / ; Eva Galinder / ; Eduardo Ucar / ; Manuel Gorordo / ; Arantza Pacho / ; Iñaki Torre / ; Francisco García / ; Olaia Fernandez / ; Flores Torre / ; Aintzane Ruiz Diez / ; Joaquín Belzunegui / ; Paloma Vela / ; Jovaní / ; Cristina Fernández / ; Miguel Belmonte / ; José A González / ; Francisco Navarro Blasco / ; Juan Tovar Beltran / ; José Raúl Noguera / ; Mauricio Minguez / ; Francisco Pérez / ; Pascual Muñoz / ; Martínez / ; Alcañiz / ; Antonio Gracia Pérez / ; Juan Antonio Castellano / ; Antonio Pérez / ; Isabel González -Cruz /
Comments/Corrections
Comment In:
J Comp Eff Res. 2012 Nov;1(6):481-4   [PMID:  24236466 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Near misses of ACR/EULAR criteria for remission: effects of patient global assessment in Boolean and...
Next Document:  The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with th...