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

Marlies Blom, Wietske Kievit, Jaap Fransen, Ina H. Kuper, Alfons A. den Broeder, Carla M.A. De Gendt, Tim L. Jansen, Herman L.M. Brus, Mart A.F.J. van de Laar, Piet L.C.M. van Riel

    Research output: Contribution to journalArticleAcademicpeer-review

    40 Citations (Scopus)

    Abstract

    OBJECTIVE:To investigate whether the reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent influences the effect of a second TNF blocking agent.

    METHODS:Data were used from 2 Dutch registries including patients with rheumatoid arthritis (RA) treated with TNF blocking agents. Patients were divided into 3 groups based on reason for discontinuation of the first: nonresponse, loss of response, or adverse events. The primary outcome was the change from baseline of the disease activity (by DAS28) at 6 months, corrected for the baseline DAS28 score. Secondary outcomes were the change from baseline at 3 months, EULAR response rates, and the percentages of patients who reached a DAS28 score < or = 3.2 at 3 and at 6 months.

    RESULTS:In total, 49 patients who failed due to nonresponse, 75 due to loss of response, and 73 due to adverse events were included. At 6 months, the change of DAS28 score from baseline did not differ significantly between the groups (-0.6 to -1.3; p > or = 0.173) and similar good and moderate response rates were found (12% to 18%, p > or = 0.523, and 34% to 55%, p > or = 0.078, respectively). The secondary outcomes were also comparable between the 3 groups.

    CONCLUSION:The results of our observational study suggest that a second TNF blocking agent may be effective after failure of the first, regardless of the reason for discontinuation of the first TNF blocking agent.

    Original languageEnglish
    Pages (from-to)2171-7
    JournalRheumatology
    Volume36
    Issue number10
    DOIs
    Publication statusPublished - 2009

    Keywords

    • METIS-265947

    Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

    Cite this