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ORIGINAL PAPER
Adalimumab treatment in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis in therapeutic programmes – personal experience
Online publication date: 2013-03-05
Reumatologia 2013;51(1):9-14
KEYWORDS
ABSTRACT
The objective of the study was to investigate the effects and safety of adalimumab (ADA) therapy in the national therapeutic programme, in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
Material and methods: The process of ADA therapy was analysed in 41 patients (24 RA, 11 AS, 6 PsA). Patients were qualified, according to the rules of the therapeutic programme of the National Health Service, due to high disease activity, despite previous treatment. Monitoring of patients was performed according to the requirements of the therapeutic programme. ADA was given subcutaneously 40 mg every other week.
Results: In the RA group, an adequate response to therapy was observed in 13 patients (54.2%): remission in 8 (33.3%) and low disease activity in 5 (20.9%), which continued in 5 patients after ADA cessation, for a mean of 4.5 months. Primary inefficacy after 3 months of therapy (lack of adequate response) was observed in 4 (16.7%), after 6 months of therapy (lack of remission/low disease activity) in 10 (41.7%). During remission/low activity period, exacerbation of RA was observed in 6/13 patients; in 2/13 secondary inefficacy was observed.
In the AS group, in 1 patient (9.1%) primary inefficacy was observed. In 10 (90.9%) low disease activity was achieved in 9 patients (90.9%), which continued for a mean of 5.4 months. During the improvement period, after cessation of ADA, 8/10 patients experienced exacerbation; secondary inefficacy was observed in 1/10 patients. In the PsA group, low disease activity was achieved in 5 patients (83.3%) during ADA administration; in 1 (16.7%) primary inefficacy was observed. In all treated patients, adverse events were noted in 17/41 (41.5%): infections (urinary, respiratory tract, viral), injection site reactions. They resulted in cessation of ADA therapy in 5 patients (4 RA patients and 1 AS patient). The number of adequate responses to ADA treatment was statistically significantly higher in AS than in RA patients (p = 0.04).
Conclusions: Treatment of ADA is a safe and effective form of therapy in patients with RA, AS and PsA, those with persistent high disease activity and non-responders to previous therapy.
Material and methods: The process of ADA therapy was analysed in 41 patients (24 RA, 11 AS, 6 PsA). Patients were qualified, according to the rules of the therapeutic programme of the National Health Service, due to high disease activity, despite previous treatment. Monitoring of patients was performed according to the requirements of the therapeutic programme. ADA was given subcutaneously 40 mg every other week.
Results: In the RA group, an adequate response to therapy was observed in 13 patients (54.2%): remission in 8 (33.3%) and low disease activity in 5 (20.9%), which continued in 5 patients after ADA cessation, for a mean of 4.5 months. Primary inefficacy after 3 months of therapy (lack of adequate response) was observed in 4 (16.7%), after 6 months of therapy (lack of remission/low disease activity) in 10 (41.7%). During remission/low activity period, exacerbation of RA was observed in 6/13 patients; in 2/13 secondary inefficacy was observed.
In the AS group, in 1 patient (9.1%) primary inefficacy was observed. In 10 (90.9%) low disease activity was achieved in 9 patients (90.9%), which continued for a mean of 5.4 months. During the improvement period, after cessation of ADA, 8/10 patients experienced exacerbation; secondary inefficacy was observed in 1/10 patients. In the PsA group, low disease activity was achieved in 5 patients (83.3%) during ADA administration; in 1 (16.7%) primary inefficacy was observed. In all treated patients, adverse events were noted in 17/41 (41.5%): infections (urinary, respiratory tract, viral), injection site reactions. They resulted in cessation of ADA therapy in 5 patients (4 RA patients and 1 AS patient). The number of adequate responses to ADA treatment was statistically significantly higher in AS than in RA patients (p = 0.04).
Conclusions: Treatment of ADA is a safe and effective form of therapy in patients with RA, AS and PsA, those with persistent high disease activity and non-responders to previous therapy.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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