Effectiveness of adalimumab for rheumatoid arthritis in patients with a history of TNF-antagonist therapy in clinical practice
Effectiveness of adalimumab for rheumatoid arthritis in patients with a history of TNF-antagonist therapy in clinical practice
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DOI：
10.1093/rheumatology/kem091
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发表时间：
2007-07-01
期刊：
影响因子：
5.5
通讯作者：
Burmester, G. R.
中科院分区：
文献类型：
--
作者：
Bombardieri, S.;Ruiz, A. A.;Burmester, G. R.
Objective.评价阿达木单抗治疗因任何原因停用肿瘤坏死因子（TNF）拮抗剂的类风湿关节炎（RA）患者的有效性和安全性。ReAct（活动性风湿性关节炎研究）是一项大型开放标签试验，招募了既往接受过传统疾病缓解抗风湿药物或生物反应调节剂治疗的活动性RA成人。患者接受阿达木单抗40 mg皮下给药，每隔一周一次，持续12周，并允许进入可选的长期扩展期。阿达木单抗有效性的测量包括美国风湿病学会（ACR）和欧洲抗风湿病联盟（EULAR）反应标准、疾病活动性评分28（DAS 28）和健康评估问卷残疾指数（HAQ DI）。在6610例患者中，899例有依那西普和/或英夫利西单抗治疗史;这些患者从阿达木单抗治疗中获得了实质性临床获益。在第12周，60%的患者有ACR 20，33%的患者有ACR 50应答; 76%的患者有中度应答，23%的患者有良好EULAR应答。此外，12%达到DAS 28 < 2.6，表明临床缓解，13%达到HAQ DI评分
Objective. To evaluate the effectiveness and safety of adalimumab in patients with rheumatoid arthritis (RA) who previously discontinued tumour necrosis factor (TNF) antagonists for any reason in clinical practice.Methods. ReAct (Research in Active Rheumatoid Arthritis) was a large, open-label trial that enrolled adults with active RA who had previously been treated with traditional disease-modifying anti-rheumatic drugs or biological response modifiers. Patients self-administered adalimumab 40 mg subcutaneously every other week for 12 weeks and were allowed to enter an optional long-term extension phase. Measures of adalimumab effectiveness included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) response criteria, Disease Activity Score 28 (DAS28) and the Health Assessment Questionnaire Disability Index (HAQ DI).Results. Of 6610 patients, 899 had a history of etanercept and/or infliximab therapy; these patients experienced substantial clinical benefit from adalimumab treatment. At week 12, 60% of patients had an ACR20 and 33% had an ACR50 response; 76% had a moderate and 23% had a good EULAR response. In addition, 12% achieved a DAS28 < 2.6, indicating clinical remission, and 13% achieved a HAQ DI score