|
Gain of a major response by switching between different available biological agents in rheumatoid arthritis |
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| Results |
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|
|
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| Study |
Number of patients |
Switch type |
ACR20 |
ACR50 |
ACR70 |
DAS44 <1.6 or DAS28 <2.6 |
ΔDAS P < 0.05 |
Evidence levela |
Strengtha |
|
|
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| Anti-TNFα blockers |
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| [3] |
25 |
IFX → ETA |
64% |
23% |
5% |
- |
- |
3b |
B |
| [4] |
95 |
IFX → ETA |
38% |
24% |
15% |
- |
6.46 → 4.97 |
3b |
B |
| [5] |
28 |
ETA → IFX |
62% |
30.7% |
- |
15.4% |
5.2 → 4 |
3b |
B |
| [6] |
6,610 |
ETA/IFX → ADA |
60% |
33% |
13% |
12% |
31% (-1.9 ± 1.4) |
2b |
B |
| [7] |
25 |
IFX → ADA |
75% |
50% |
33% |
- |
5.6 → 3.2 |
3b |
B |
| Anti-CD20 |
|||||||||
| [8] |
311 |
Anti-TNFα → RTX |
51% |
27% |
12% |
9% |
15% (ΔDAS > 1.2) |
1b |
A |
| SR CTLA-4 |
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| [10] |
391 |
Anti-TNFα → ABA |
50.4% |
20.3% |
10.2% |
10.0% |
- |
1b |
A |
| [11] |
1,046 |
Anti-TNFα → ABA |
- |
- |
- |
13.0% |
56.1% (-2.0) |
1b |
A |
| Interleukin-6R inhibitor |
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| [12] |
499 |
Anti-TNFα → TOC |
50.0% |
28.8% |
12.4% |
30.1% |
- |
1b |
A |
|
aAccording to the levels of evidence of the Centre for Evidence-Based Medicine (Oxford, UK). ΔDAS P <0.05, significant difference in disease activity score value before and after switching; ABA, abatacept; ACR20, American College of Rheumatology 20% improvement criteria; ACR50, American College of Rheumatology 50% improvement criteria; ACR70, American College of Rheumatology 70% improvement criteria; ADA, adalimumab; anti-TNFα, anti-tumor necrosis factor-alpha; DAS28, disease activity score using 28 joint counts; DAS44, disease activity score using 44 joint counts; ETA, etanercept; IFX, infliximab; RTX, rituximab; TOC, tocilizumab (8 mg/kg group). | |||||||||
Alivernini et al. Arthritis Research & Therapy 2009 11:R163 doi:10.1186/ar2848 |
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