Professional paper

https://doi.org/10.33004/reumatizam-66-1-1

Effectiveness of biologics in patients with rheumatoid arthritis – a single-center experience

Marijana Šupe ; 1General Hospital of Šibenik-Knin County, Šibenik, Croatia
Ana Gudelj Gračanin ; Division of Rheumatology, Allergology, and Clinical Immunology, Department of Internal Medicine, School of Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia
Marko Lucijanić ; Division of Hematology, Department of Medicine, School of Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia
Jadranka Morović-Vergles ; Division of Rheumatology, Allergology, and Clinical Immunology, Department of Internal Medicine, School of Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia

Abstract

In the case of ineffectiveness of synthetic disease-modifying anti rheumatic drugs (DMARD s) in the treatment of patients with active rheumatoid arthritis (RA ), we can use one of the biological or biosimilar drugs according to the Croatian Society for Rheumatology guidelines from 2013. Despite the achieved remission and better disease control,
according to literature data up to 60% of patients develop primary or secondary ineffectiveness of the drug. In order to determine primary or secondary ineffectiveness of the drug in our patients, we retrospectively analyzed data from patients treated with biological drugs at the Division of Clinical Immunology, Allergology, and Rheumatology of the Department of Internal Medicine of the University of Zagreb School of Medicine, Clinical Hospital Dubrava, in the period 2008–2016. The study included 88 patients, 25 men and 63 women. The activity of the disease was monitored using the DAS 28(CRP) index. In 39 patients (44%), 10 men and 29 women, the first biological drug was replaced with another. Out of these 39 patients, 30 (77%) achieved remission on the second line of treatment. Seven (18%) patients had to be given a third biological drug because of the ineffectiveness of the second drug, while two patients had to be given a fourth or fifth biological drug. The most common cause of discontinuation of the drug was clinical ineffectiveness, which means that the high activity of the disease was maintained. We did not find a statistically significant difference in the titer of rheumatoid factor (RF) and/or anti-citrulatory peptide (anti-CC P) or smoking status in patients treated with a single biological agent and those in which two or more biological drugs had to be used.

Keywords

Arthritis, rheumatoid – drug therapy, immunology; Biological factors – therapeutic use; Antirheumatic agents – therapeutic use; Tumor necrosis factor-alpha – antagonists and inhibitors; Antibodies, monoclonal – immunology, therapeutic use; Severity of ilness index; Remission induction; Treatment outcome

Hrčak ID:

226235

URI

https://hrcak.srce.hr/226235

Publication date:

16.10.2019.

Article data in other languages: croatian

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