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Treatment response to a second or third TNF-inhibitor in RA: results from the South Swedish Arthritis Treatment Group

J A Karlsson1, L E Kristensen, M C Kapetanovic

  • 1Department of Rheumatology, Lund University Hospital, SE 221 85 Lund, Sweden.

Rheumatology (Oxford, England)
|February 29, 2008
PubMed
Abstract

Insights

Response rates for rheumatoid arthritis patients switching anti-tumor necrosis factor (anti-TNF) therapy are lower for those switching twice. Baseline predictors for second-line anti-TNF treatment response include lower age and HAQ scores.

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Anti-tumor necrosis factor (anti-TNF) therapies are crucial for RA management.
  • Understanding treatment response in patients switching anti-TNF agents is vital for optimizing care.

Purpose of the Study:

  • To evaluate treatment response rates in RA patients receiving second- and third-line anti-TNF therapy.
  • To identify baseline predictors of response to second-line anti-TNF treatment.

Main Methods:

  • Prospective, observational study of RA patients switching anti-TNF therapy.
  • Patients categorized as first-time switchers (n=337) or second-time switchers (n=36).
  • Response assessed at 3 months using ACR and EULAR criteria; logistic regression used for predictor analysis.

Main Results:

  • ACR20 response rates were 51% for first-time and 35% for second-time switchers.
  • EULAR overall response rates were 71% and 58%, respectively.
  • Predictors for second-line response included lower age, lower HAQ, higher DAS28, and prior adverse events.

Conclusions:

  • Response rates to second-line anti-TNF therapy are lower than in anti-TNF-naïve patients.
  • Significantly lower response rates in second-time switchers suggest alternative therapies should be considered.
  • Identified predictors may aid in selecting patients for second-line anti-TNF treatment, but vary by response criteria.

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