Rheumatology Advance Access published online on May 3, 2005
Rheumatology, doi:10.1093/rheumatology/keh673
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Guy's and St Thomas' Foundation Hospital NHS Trust, London, UK
* To whom correspondence should be addressed. Objective. To assess the efficacy and safety of the fully human recombinant monoclonal anti-TNF antibody adalimumab in routine clinical practice, including comparison of patients with and without previous anti-TNF exposure. Methods. We prospectively studied the outcome of 70 rheumatoid arthritis patients treated with adalimumab in normal clinical practice. The primary outcome measures were Disease Activity Score 28 (DAS28), EULAR (European League Against Rheumatism) response and Health Assessment Questionaire (HAQ). Results. Seventy-seven per cent achieved a EULAR response (26% good, 51% moderate) and 19% were in remission. The mean decrease in DAS28 was 2.1 (6.3-4.2; P<0.001). The mean decrease in HAQ score was 0.34 (2.07-1.73; P<0.001), 66% achieving a clinically significant decrease of greater than 0.22. Twenty-three per cent stopped treatment because of side-effects (7%) or failure to respond (16%). Of the 26 patients who had previously tried 29 biologicals, 65% responded to adalimumab. There was no significant difference in the change in mean DAS (P = 0.69) or HAQ (P = 0.88) between groups with and without previous anti-TNF exposure. Of the 13 patients with previous secondary failure to infliximab, 77% responded to adalimumab. Patients with previous secondary failure had significantly better improvement in DAS (P = 0.023) than patients with previous primary failure. Conclusion. Our clinical experience confirms that adalimumab is effective and safe in the treatment of RA. It also shows adalimumab is effective in patients with previous biological failures, particularly patients with secondary failure to infliximab.
Received September 16, 2004
Accepted April 1, 2005
Original Papers
Adalimumab in clinical practice. Outcome in 70 rheumatoid arthritis patients, including comparison of patients with and without previous anti-TNF exposure
2 GKT School of Medicine, London, UK
B. Kirkham, E-mail: bruce.kirkham{at}gstt.sthames.nhs.uk
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. BLOM, W. KIEVIT, J. FRANSEN, I. H. KUPER, A. A. den BROEDER, C. M.A. De GENDT, T. L. JANSEN, H. L.M. BRUS, M. A.F.J. van de LAAR, and P. L.C.M. van RIEL The Reason for Discontinuation of the First Tumor Necrosis Factor (TNF) Blocking Agent Does Not Influence the Effect of a Second TNF Blocking Agent in Patients with Rheumatoid Arthritis J Rheumatol, October 1, 2009; 36(10): 2171 - 2177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Karlsson, L. E. Kristensen, M. C. Kapetanovic, A. Gulfe, T. Saxne, and P. Geborek Treatment response to a second or third TNF-inhibitor in RA: results from the South Swedish Arthritis Treatment Group Register Rheumatology, April 1, 2008; 47(4): 507 - 513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. E. Walsh, P. Minnock, C. Slattery, N. Kennedy, F. Pang, D. J. Veale, B. Bresnihan, and O. FitzGerald Quality of life and economic impact of switching from established infliximab therapy to adalimumab in patients with rheumatoid arthritis Rheumatology, July 1, 2007; 46(7): 1148 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Greenwood, J. Rathi, A. J. Hakim, D. L. Scott, and D. V. Doyle Regression to the mean using the disease activity score in eligibility and response criteria for prescribing TNF-{alpha} inhibitors in adults with rheumatoid arthritis Rheumatology, July 1, 2007; 46(7): 1165 - 1167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bombardieri, A. A. Ruiz, P. Fardellone, P. Geusens, F. McKenna, K. Unnebrink, U. Oezer, S. Kary, H. Kupper, G. R. Burmester, et al. Effectiveness of adalimumab for rheumatoid arthritis in patients with a history of TNF-antagonist therapy in clinical practice Rheumatology, July 1, 2007; 46(7): 1191 - 1199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Solau-Gervais, N. Laxenaire, B. Cortet, S. Dubucquoi, B. Duquesnoy, and R.-M. Flipo Lack of efficacy of a third tumour necrosis factor {alpha} antagonist after failure of a soluble receptor and a monoclonal antibody Rheumatology, September 1, 2006; 45(9): 1121 - 1124. [Abstract] [Full Text] [PDF]
|
|