| Effectiveness of switching between TNF inhibitors in ankylosing spondylitis: data from the NOR-DMARD register. | |
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MedLine Citation:
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PMID: 21062852 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the effectiveness of switching to a second tumour necrosis factor inhibitor (TNFi) in patients with ankylosing spondylitis (AS). METHODS: Data were extracted from an ongoing longitudinal observational multicentre study in Norway. This study included anti-TNF naïve patients with AS starting treatment with a TNFi as well as treatment with a second TNFi in these same patients. Effectiveness data and 2-year drug survival were compared between switchers and non-switchers and within switchers (first and second TNFi). RESULTS: 514 anti-TNF naïve patients with AS were included; 77 patients switched to a second TNFi while 437 patients did not switch. The percentages of non-switchers using etanercept, infliximab or adalimumab were 53%, 32% and 15%, and the percentages of first and second TNFi in the switchers were 42%, 53% and 5% and 40%, 23% and 36%, respectively. The reason for switching was insufficient response (IR) in 30, adverse events (AEs) in 44 and not reported in 3 patients. Baseline disease activity was similar between the groups. Three-month BASDAI 50 and ASAS 40 responses were achieved by 49% and 38% of non-switchers, by 25% and 30% of switchers after the first TNFi and by 28% and 31% after the second TNFi. The 3-month disease activity level was higher for switchers on the second TNFi than for non-switchers. Drug withdrawal rate was higher during the second TNFi among switchers than for non-switchers (p=0.001). No difference was found in the effectiveness of the second TNFi between switchers due to IR and AE. CONCLUSION: This study confirms that switching to a second TNFi can be effective in AS and can be as useful as in rheumatoid arthritis, although overall effectiveness seems to be somewhat lower than in non-switchers. |
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Authors:
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E Lie; D van der Heijde; T Uhlig; K Mikkelsen; E Rødevand; W Koldingsnes; C Kaufmann; T K Kvien |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-11-09 |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: 70 ISSN: 1468-2060 ISO Abbreviation: Ann. Rheum. Dis. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: England |
Other Details:
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Languages: eng Pagination: 157-63 Citation Subset: IM |
Affiliation:
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Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. elisabeth_lie@yahoo.no |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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