Abstract
Background and aim: Biological drugs such as adalimumab, infliximab and etanercept dramatically improved the treatment of rheumatoid arthritis. However, there are some patients who do not respond to these tumor necrosis factor (TNF) inhibitors. We investigated whether switching therapy to adalimumab from other TNF inhibitor is effective for those who do not respond infliximab or etanercept.
Method: Patients who did not respond to infliximab or etanercept were enrolled in the study (n＝55; male/female, 13/42; mean age, 59.7 y.o.; mean duration of disease,13 y. and 9 mo.). Patients received adalimumab every other week, and efficacy was assessed using EULAR criteria. Efficacy and safety were evaluated 24 weeks after initiation of adalimumab administration.
Results: Among patients enrolled in the study, 36 (65.5%) cases completed the 24-week administration. The number of patients showing moderate/good response was 30 (54.5%). Adalimumab had fast onset and improved DAS28-CRP and MMP-3 immediately four weeks after initiation of administration, and the efficacy remained after 24 weeks. Adverse events were reported from 32 (58.2%) cases. Major events were rash/itching (18/55, 32.7%) and erythema at injection site (12/55, 21.8%). Three serious events (thrombopenia, back abscess after acupuncture and wound infection after cervical surgery) were reported, but none of them was considered to be associated with adalimumab. Only seven cases were discontinued due to adverse events.
