Reumatizam, Vol. 66 No. 1, 2019.
Stručni rad
https://doi.org/10.33004/reumatizam-66-1-1
Effectiveness of biologics in patients with rheumatoid arthritis – a single-center experience
Marijana Šupe
; Opća bolnica Šibensko-kninske županije, Šibenik, Hrvatska
Ana Gudelj Gračanin
; Zavod za kliničku imunologiju, alergologiju i reumatologiju, Klinika za unutarnje bolesti Medicinskog fakulteta Sveučilišta u Zagrebu, Klinička bolnica Dubrava, Zagreb
Marko Lucijanić
; Zavod za hematologiju, Klinika za unutarnje bolesti Medicinskog fakulteta Sveučilišta u Zagrebu, Klinička bolnica Dubrava, Zagreb
Jadranka Morović-Vergles
; Zavod za kliničku imunologiju, alergologiju i reumatologiju, Klinika za unutarnje bolesti Medicinskog fakulteta Sveučilišta u Zagrebu, Klinička bolnica Dubrava, Zagreb
Sažetak
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.
Ključne riječi
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
Datum izdavanja:
16.10.2019.
Posjeta: 2.191 *