Document Detail

A comparative effectiveness study of adalimumab, etanercept and infliximab in biologically naive and switched rheumatoid arthritis patients: results from the US CORRONA registry.
MedLine Citation:
PMID:  22294625     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare the effectiveness of anti-tumour necrosis factor (TNF) agents in biologically naive and 'switched' rheumatoid arthritis (RA) patients.
METHODS: RA patients enrolled in the CORRONA registry newly prescribed adalimumab (n=874), etanercept (n=640), or infliximab (n=728) were stratified based on previous anti-TNF use. Clinical effectiveness at 6, 12 and 24 months was examined using the modified American College of Rheumatology response criteria (mACR20/50/70) and achievement of remission (28-joint disease activity score (DAS28) and clinical disease activity index (CDAI)) in unadjusted and adjusted analyses. The persistence of anti-TNF treatment was examined using Cox proportional hazard models.
RESULTS: Among 2242 patients (1475 biologically naive, 767 switchers), mACR20, 50 and 70 responses were similar (p>0.05) for adalimumab, etanercept and infliximab at all time points, as were rates of CDAI and DAS28 remission (p>0.05). Response and remission outcomes were consistently inferior for switched versus biologically naive patients. The adjusted OR for achieving an mACR20 response was 0.54 (95% CI 0.38 to 0.76) in first-time switchers and 0.42 (95% CI 0.23 to 0.78) in second-time switchers versus biologically naive patients at 6 months. The adjusted OR for achieving DAS28 remission were 0.29 (95% CI 0.15 to 0.58) for first-time switchers and 0.26 (95% CI 0.08 to 0.84) for second-time switchers. Persistence was higher in biologically naive patients, for whom persistence was highest with infliximab.
CONCLUSIONS: No differences in rates of drug response or remission were observed among the three anti-TNF. Infliximab was associated with greater persistence in biologically naive patients. Response, remission and persistence outcomes were diminished for patients who switched anti-TNF.
Jeffrey D Greenberg; George Reed; Dennis Decktor; Leslie Harrold; Daniel Furst; Allan Gibofsky; Ralph Dehoratius; Mitsumasa Kishimoto; Joel M Kremer;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-01-30
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  71     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-14     Completed Date:  2012-08-21     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1134-42     Citation Subset:  IM    
New York University Hospital for Joint Diseases, Department of Rheumatology, 301 East 17th Street, suite 1410, New York, NY 10003, USA.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized / therapeutic use
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  pathology,  physiopathology
Drug Substitution
Health Status
Immunoglobulin G / therapeutic use
Immunologic Factors / therapeutic use*
Joints / pathology,  physiopathology
Middle Aged
Receptors, Tumor Necrosis Factor / therapeutic use
Remission Induction
Severity of Illness Index
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Immunologic Factors; 0/Receptors, Tumor Necrosis Factor; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein; FYS6T7F842/adalimumab

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