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Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors.
- Source :
-
Modern rheumatology [Mod Rheumatol] 2012 Apr; Vol. 22 (2), pp. 195-201. Date of Electronic Publication: 2011 Sep 06. - Publication Year :
- 2012
-
Abstract
- We aimed to investigate whether delayed treatment with tumor necrosis factor (TNF) inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs (DMARDs) was effective among patients with very early rheumatoid arthritis (RA) with poor prognosis factors. We examined 22 patients with very early RA who were positive for anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. The mean disease duration at entry was 14.1 weeks. A treat-to-target strategy, aiming at simplified disease activity index (SDAI) remission, was initiated with synthetic DMARDs. SDAI remission was not achieved in 9 of the 22 patients with synthetic DMARDs alone, and TNF inhibitors were added in these patients. SDAI values in these 9 patients were further examined for the following 6 months. The TNF inhibitors (infliximab 8, etanercept 1) were added at a mean interval of 34.1 weeks after the initiation of synthetic DMARDs. SDAI remission was achieved in 4 of the 9 patients (44.4%) at 3 months and in 8 of the 9 patients (88.9%) at 6 months after the introduction of the TNF inhibitors. Radiographic damage had not progressed in these patients. Delayed treatment with TNF inhibitors is effective and tolerable for patients with very early RA with poor prognosis factors.
- Subjects :
- Arthritis, Rheumatoid complications
Arthritis, Rheumatoid diagnosis
Arthritis, Rheumatoid physiopathology
Autoantibodies blood
Early Diagnosis
Etanercept
Female
Humans
Immunoglobulin M immunology
Infliximab
Joints pathology
Joints physiopathology
Magnetic Resonance Imaging
Male
Middle Aged
Peptides, Cyclic blood
Prognosis
Prospective Studies
Recovery of Function
Remission Induction
Rheumatoid Factor blood
Synovitis diagnosis
Synovitis etiology
Synovitis physiopathology
Time Factors
Treatment Failure
Treatment Outcome
Antibodies, Monoclonal therapeutic use
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid drug therapy
Immunoglobulin G therapeutic use
Receptors, Tumor Necrosis Factor therapeutic use
Synovitis drug therapy
Tumor Necrosis Factor-alpha antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1439-7609
- Volume :
- 22
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Modern rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 21898075
- Full Text :
- https://doi.org/10.1007/s10165-011-0511-y