Sequential use of biologic therapy in rheumatoid arthritis

Buch, Maya H

doi:10.1097/bor.0b013e328337bd01

Cited by 29 publications

(13 citation statements)

References 53 publications

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“…[4][5][6][7][8][9][10][11] However, there has been a concern that RTX might not be as effective in preventing radiographic damage as anti-TNF agents. While we could confi rm the relative benefi t of RTX over alternative anti-TNF agents on disease activity, we found a similar rate of radiographic erosion progression between these two treatments.…”

Section: Discussionmentioning

confidence: 99%

“…However, disease activity may greatly infl uence the assessment of functional capacity particularly in early disease, 28 which would explain the benefi cial trend in the RTX group, as this agent has a more favourable impact on RA disease activity in this setting. [4][5][6][7][8][9][10][11] Observational studies have inherent limitations when comparing the effectiveness of different treatment options. Selection bias may arise because assignment to these agents is not performed randomly.…”

Section: Discussionmentioning

confidence: 99%

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Evolution of radiographic joint damage in rituximab-treated versus TNF-treated rheumatoid arthritis cases with inadequate response to TNF antagonists

Finckh

Möller

Walker³

et al. 2012

Annals of the Rheumatic Diseases

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BackgroundObservational studies have suggested that patients with rheumatoid arthritis (RA) who experience inadequate response to anti-tumour necrosis factor (anti-TNF) agents respond more favourably to rituximab (RTX) than to an alternative anti-TNF agent. However, the relative effectiveness of these agents on long-term outcomes, particularly in radiographic damage, remains unclear.ObjectiveTo compare the effectiveness of RTX against anti-TNF agents in preventing joint damage in patients with RA who have experienced inadequate response to at least one prior anti-TNF agent.MethodsThis is a prospective cohort study within the Swiss registry of patients with RA who discontinued at least one anti-TNF agent and subsequently received either RTX or an alternative anti-TNF agent. The primary outcome, progression of radiographic joint erosions (Ratingen erosion score)over time, and the secondary outcome, functional disability (Health Assessment Questionnaire Disability Index), were analysed using regression models for longitudinal data and adjusted for potential confounders.ResultsOf the 371 patients included, 104 received RTX and 267 received an alternative anti-TNF agent. During the 2.6-year median follow-up period, the rates of Ratingen erosion score progression were similar between patients taking RTX and patients taking an alternative anti-TNF agent (p=0.67). The evolution of the Health Assessment Questionnaire score was statistically significantly better in the RTX group (p=0.016), but the magnitude of the effect was probably not clinically relevant.ConclusionThis observational study suggests that RTX is as effective as an alternative anti-TNF agent in preventing erosions in patients with RA who have previously experienced inadequate response to anti-TNF agents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evolution of radiographic joint damage in rituximab-treated versus TNF-treated rheumatoid arthritis cases with inadequate response to TNF antagonists

Finckh

Möller

Walker³

et al. 2012

Annals of the Rheumatic Diseases

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“…[19] advises caution when RTX and TNFblockers are used after one another. However, a recent review by Buch [49] reports that no safety signals are currently present with biological sequencing. .…”

Section: Case Reportsmentioning

confidence: 95%

The potential risk of infections during (prolonged) rituximab therapy in rheumatoid arthritis

Brinkman

Laar

Jansen

et al. 2011

Expert Opinion on Drug Safety

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In present literature RTX appears to be safe for up to five courses. In this review, important drawbacks of current research are discussed. Longer follow-up time is needed to make relevant conclusions on RTX safety with regard to infectious complications. Prolonged RTX therapy causes subsequent B-cell depletion. Eventually, plasma cells disappear, causing hypogammaglobulinemias and subsequent problems in immunity. The formation of new plasma cells is halted due to a lack of B-cells. Attention needs to be focused on the status of immunoglobulins and the role this plays in the occurrence of infections. Until a complete, long-term safety profile of RTX is available, it cannot be considered safe with regard to the incidence of infectious complications.

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“…Furthermore, small inhibitory molecules directed against specific signalling molecules have been developed—for example, imatinib mesylate, which targets the tyrosine kinase activity of c-ABL, c-Kit and the platelet-derived growth factor (PDGF)-receptor 1 2. The application of these therapeutics has improved the treatment results in various inflammatory disorders, such as rheumatoid arthritis, psoriasis, systemic sclerosis as well as specific uveitis entities 3–7.…”

Section: Introductionmentioning

confidence: 99%

Whole orbital tissue culture identifies imatinib mesylate and adalimumab as potential therapeutics for Graves' ophthalmopathy

Steensel

Hagen

Paridaens

et al. 2011

British Journal of Ophthalmology

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Sequential use of biologic therapy in rheumatoid arthritis

Abstract: Although biological sequencing is well established, optimal approach represents a significant knowledge gap; well designed clinical studies with associated mechanistic investigation are necessary to identify disease subgroups that would benefit from one sequence over another.

Cited by 29 publications

References 53 publications

Evolution of radiographic joint damage in rituximab-treated versus TNF-treated rheumatoid arthritis cases with inadequate response to TNF antagonists

Evolution of radiographic joint damage in rituximab-treated versus TNF-treated rheumatoid arthritis cases with inadequate response to TNF antagonists

The potential risk of infections during (prolonged) rituximab therapy in rheumatoid arthritis

Whole orbital tissue culture identifies imatinib mesylate and adalimumab as potential therapeutics for Graves' ophthalmopathy

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