Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/1693
Título : DAS-28-based EULAR response and HAQ improvement in rheumatoid arthritis patients switching between TNF antagonists
Autor : Navarro-Sarabia, Federico
Ruiz-Montesinos, Dolores
Hernandez, Blanca
Navarro-Compán, Victoria
Marsal, Sara
Barcelo, Mireia
Perez-Pampín, Eva
Gómez-Reino, Juan J
Filiación: [Navarro-Sarabia,F; Ruiz-Montesinos,D; Hernandez,B; Navarro-Compán,V] Rheumatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain. [Marsal,S; Barcelo,M] Rheumatology Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain. [Perez-Pampín,E; Gómez-Reino,JJ] Rheumatology Service, Hospital Clínico de Santiago and Department of Medicine, USC, Santiago, Spain.
Palabras clave : Tumor necrosis factor-alpha
Antirreumáticos
Artritis reumatoide
Bases de datos como asunto
Esquema de medicación
Valor predictivo de las pruebas
Cuestionarios
Insuficiencia del tratamiento
Factor de necrosis tumoral alfa
MeSH: Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antirheumatic Agents
Medical Subject Headings::Diseases::Musculoskeletal Diseases::Joint Diseases::Arthritis::Arthritis, Rheumatoid
Medical Subject Headings::Information Science::Information Science::Information Storage and Retrieval::Databases as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Schedule
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Sensitivity and Specificity::Predictive Value of Tests
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Information Science::Information Science::Data Collection::Questionnaires
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Phenomena and Processes::Physical Phenomena::Time::Time Factors
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Monokines::Tumor Necrosis Factor-alpha
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Fecha de publicación : 23-Jul-2009
Editorial : BioMed Central
Cita Bibliográfica: Navarro-Sarabia F, Ruiz-Montesinos D, Hernandez B, Navarro-Compán V, Marsal S, Barcelo M, et al. DAS-28-based EULAR response and HAQ improvement in rheumatoid arthritis patients switching between TNF antagonists. BMC Musculoskelet Disord; 2009 10:91
Abstract: INTRODUCTION No definitive data are available regarding the value of switching to an alternative TNF antagonist in rheumatoid arthritis patients who fail to respond to the first one. The aim of this study was to evaluate treatment response in a clinical setting based on HAQ improvement and EULAR response criteria in RA patients who were switched to a second or a third TNF antagonist due to failure with the first one. METHODS This was an observational, prospective study of a cohort of 417 RA patients treated with TNF antagonists in three university hospitals in Spain between January 1999 and December 2005. A database was created at the participating centres, with well-defined operational instructions. The main outcome variables were analyzed using parametric or non-parametric tests depending on the level of measurement and distribution of each variable. RESULTS Mean (+/- SD) DAS-28 on starting the first, second and third TNF antagonist was 5.9 (+/- 2.0), 5.1 (+/- 1.5) and 6.1 (+/- 1.1). At the end of follow-up, it decreased to 3.3 (+/- 1.6; Delta = -2.6; p > 0.0001), 4.2 (+/- 1.5; Delta = -1.1; p = 0.0001) and 5.4 (+/- 1.7; Delta = -0.7; p = 0.06). For the first TNF antagonist, DAS-28-based EULAR response level was good in 42% and moderate in 33% of patients. The second TNF antagonist yielded a good response in 20% and no response in 53% of patients, while the third one yielded a good response in 28% and no response in 72%. Mean baseline HAQ on starting the first, second and third TNF antagonist was 1.61, 1.52 and 1.87, respectively. At the end of follow-up, it decreased to 1.12 (Delta = -0.49; p < 0.0001), 1.31 (Delta = -0.21, p = 0.004) and 1.75 (Delta = -0.12; p = 0.1), respectively. Sixty four percent of patients had a clinically important improvement in HAQ (defined as > or = -0.22) with the first TNF antagonist and 46% with the second. CONCLUSION A clinically significant effect size was seen in less than half of RA patients cycling to a second TNF antagonist.
Descripción : Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/1693
Versión del editor : http://www.biomedcentral.com/1471-2474/10/91/abstract
DOI: 10.1186/1471-2474-10-91
ISSN : 1471-2474 (Online)
Appears in Collections:01- Artículos - Hospital Virgen Macarena

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