Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/1693
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dc.contributor.authorNavarro-Sarabia, Federico-
dc.contributor.authorRuiz-Montesinos, Dolores-
dc.contributor.authorHernandez, Blanca-
dc.contributor.authorNavarro-Compán, Victoria-
dc.contributor.authorMarsal, Sara-
dc.contributor.authorBarcelo, Mireia-
dc.contributor.authorPerez-Pampín, Eva-
dc.contributor.authorGómez-Reino, Juan J-
dc.date.accessioned2014-08-08T11:47:49Z-
dc.date.available2014-08-08T11:47:49Z-
dc.date.issued2009-07-23-
dc.identifier.citationNavarro-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 10:91es
dc.identifier.issn1471-2474 (Online)-
dc.identifier.otherPMC2724400-
dc.identifier.urihttp://hdl.handle.net/10668/1693-
dc.descriptionJournal Article; Multicenter Study; Research Support, Non-U.S. Gov't;es
dc.description.abstractINTRODUCTION 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.es
dc.description.sponsorshipThe study was partially funded by a grant of BMS, Spain, and by RETICS Program,RD08/0075 (RIER) from the Instituto de Salud Carlos III (ISCIII),within the VI PN de I+D+I 2008–2011.es
dc.language.isoenes
dc.publisherBioMed Centrales
dc.relation.ispartofBMC musculoskeletal disorderses
dc.subjectTumor necrosis factor-alphaes
dc.subjectAntirreumáticoses
dc.subjectArtritis reumatoidees
dc.subjectBases de datos como asuntoes
dc.subjectEsquema de medicaciónes
dc.subjectValor predictivo de las pruebases
dc.subjectCuestionarioses
dc.subjectInsuficiencia del tratamientoes
dc.subjectFactor de necrosis tumoral alfaes
dc.subject.meshMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Agedes
dc.subject.meshMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antirheumatic Agentses
dc.subject.meshMedical Subject Headings::Diseases::Musculoskeletal Diseases::Joint Diseases::Arthritis::Arthritis, Rheumatoides
dc.subject.meshMedical Subject Headings::Information Science::Information Science::Information Storage and Retrieval::Databases as Topices
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Schedulees
dc.subject.meshMedical Subject Headings::Check Tags::Femalees
dc.subject.meshMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humanses
dc.subject.meshMedical Subject Headings::Check Tags::Malees
dc.subject.meshMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Agedes
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Sensitivity and Specificity::Predictive Value of Testses
dc.subject.meshMedical 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 Studieses
dc.subject.meshMedical Subject Headings::Information Science::Information Science::Data Collection::Questionnaireses
dc.subject.meshMedical Subject Headings::Geographicals::Geographic Locations::Europe::Spaines
dc.subject.meshMedical Subject Headings::Phenomena and Processes::Physical Phenomena::Time::Time Factorses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome::Treatment Failurees
dc.subject.meshMedical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Monokines::Tumor Necrosis Factor-alphaes
dc.subject.meshMedical Subject Headings::Named Groups::Persons::Age Groups::Adultes
dc.titleDAS-28-based EULAR response and HAQ improvement in rheumatoid arthritis patients switching between TNF antagonistses
dc.typeinfo:eu-repo/semantics/articlees
dc.description.versionYeses
dc.identifier.pmid19627609-
dc.rights.accessRightsAcceso abiertoes
dc.identifier.doi10.1186/1471-2474-10-91-
dc.type.versioninfo:eu-repo/semantics/publishedes
dc.relation.publisherversionhttp://www.biomedcentral.com/1471-2474/10/91/abstractes
dc.contributor.authoraffiliation[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.es
dc.type.subtypeArtículoes
Appears in Collections:01- Artículos - Hospital Virgen Macarena

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