EDITORIAL ARTICLE
Treatment strategies in rheumatoid arthritis
Online publication date: 2013-09-11
Reumatologia 2013;51(4):239-248
KEYWORDS
rheumatoid arthritisbiological therapytargeted therapybiologicsswitchremissionanti-drug antibodiesimmunogenicity
ABSTRACT
In this editorial, the author goes through the consecutive steps of rheumatoid arthritis (RA) treatment. In brief, the recent European recommendations are presented, followed by some strategic points of methotrexate (MTX) therapy. The initiation, maintenance and switch of biological therapy are discussed. After remission or low disease activity (LDA) is reached, tapering or discontinuation of biologics may be considered. Finally, the author reviews the most relevant clinical and biological markers of personalized treatment.
REFERENCES (45)
1.
Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2010; 69: 964-975.
2.
Isaacs JD, Ferraccioli G. The need for personalised medicine for rheumatoid arthritis. Ann Rheum Dis 2011; 70: 4-7.
3.
Smolen JS, Aletaha D, Bijlsma JW, et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010; 69: 631-637.
4.
Szekanecz Z, Szanto S, Szabo Z, et al. Biologics – beyond the joints. Autoimmun Rev 2010; 9: 820-824.
5.
Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010; 69: 1580-1588.
6.
Aletaha D, Strand V, Smolen JS, Ward MM. Treatment-related improvement in physical function varies with duration of rheumatoid arthritis: a pooled analysis of clinical trial results. Ann Rheum Dis 2008; 67: 238-243.
7.
Mouterde G, Baillet A, Gaujoux-Viala C, et al. Optimizing methotrexate therapy in rheumatoid arthritis: A systematic literature review. Joint Bone Spine 2011; 78: 587-592.
8.
Furst DE, Koehnke R, Burmeister LF, et al. Increasing methotrexate effect with increasing dose in the treatment of resistant rheumatoid arthritis. J Rheumatol 1989; 16: 313-320.
9.
Bykerk V, Rowe DS, Pope JE, et al. Parenteral MTX as an initial treatment strategy for early rheumatoid arthritis: results from a nationwide cohort (abstract). Arthritis Rheum 2010; 62 (10 Suppl): 73.
10.
Bykerk VP, Jamal S, Boire G, et al. The Canadian Early Arthritis Cohort (CATCH): patients with new-onset synovitis meeting the 2010 ACR/EULAR classification criteria but not the 1987 ACR classification criteria present with less severe disease activity. J Rheumatol 2012; 39: 2071-2080. .
11.
Schnabel A, Reinhold-Keller E, Willmann V, Gross WL. Tolerability of methotrexate starting with 15 or 25 mg/week for rheumatoid arthritis. Rheumatol Int 1994; 14: 33-38.
12.
Bakker MF, Jacobs JW, Verstappen SM, Bijlsma JW. Tight control in the treatment of rheumatoid arthritis: efficacy and feasibility. Ann Rheum Dis 2007; 66 Suppl 3: iii56-60.
13.
Verstappen SM, Jacobs JW, van der Veen MJ, et al. Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial). Ann Rheum Dis 2007; 66: 1443-1449.
14.
Grigor C, Capell H, Stirling A, et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 2004; 364: 263-269.
15.
Visser K, van der Heijde D, et al. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature. Ann Rheum Dis 2009; 68: 1094-1099.
16.
Fautrel B, Guillemin F, Meyer O, et al. Choice of second-line disease-modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: a decision tree for clinical practice based on rheumatologists' preferences. Arthritis Rheum 2009; 61: 425-434.
17.
Braun J, Kastner P, Flaxenberg P, et al. Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: results of a six-month, multicenter, randomized, double-blind, controlled, phase IV trial. Arthritis Rheum 2008; 58: 73-81.
18.
van Vollenhoven RF. Switching between anti-tumour necrosis factors: trying to get a handle on a complex issue. Ann Rheum Dis 2007; 66: 849-851.
19.
Simard JF, Arkema EV, Sundström A, et al. Ten years with biologics: to whom do data on effectiveness and safety apply? Rheumatology (Oxford) 2011; 50: 204-213.
20.
Szekanecz Z, Váncsa A, Soós B, et al. Biological therapy switches in rheumatoid arthritis – on the road of personalized medicine [Hungarian]. Immunol Quarterly [Hung] 2012; 2012: 29-39.
21.
Gomez-Reino JJ, Carmona L; BIOBADASER Group. Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period. Arthritis Res Ther 2006; 8: R29.
22.
Rendas-Baum R, Wallenstein GV, Koncz T, et al. Evaluating the efficacy of sequential biologic therapies for rheumatoid arthritis patients with an inadequate response to tumor necrosis factor- inhibitors. Arthritis Res Ther 2011; 13: R25.
23.
Paccou J, Solau-Gervais E, Houvenagel E, et al. Efficacy in current practice of switching between anti-tumour necrosis factor- agents in spondyloarthropathies. Rheumatology (Oxford) 2011; 50: 714-720.
24.
Rubbert-Roth A, Finckh A. Treatment options in patients with rheumatoid arthritis failing initial TNF inhibitor therapy: a critical review. Arthritis Res Ther 2009; 11 Suppl 1: S1.
25.
Wieten L, Berlo SE. Ten Brink CB, et al. IL-10 is critically involved in mycobacterial HSP70 induced suppression of proteoglycan-induced arthritis. PLoS ONE 2009; 4: e4186.
26.
Solau-Gervais E, Laxenaire N, Cortet B, et al. Lack of efficacy of a third tumour necrosis factor alpha antagonist after failure of a soluble receptor and a monoclonal antibody. Rheumatology (Oxford) 2006; 45: 1121-1124.
27.
Cohen SB, Emery P, Greenwald MW, et al. Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy: Results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial evaluating primary efficacy and safety at twenty-four weeks. Arthritis Rheum 2006; 54: 2793-2806.
28.
Felson DT, Smolen JS, Wells G, et al. American College of Rheumatology/European League against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Ann Rheum Dis 2011; 70: 404-413.
29.
Klarenbeek NB, van der Kooij SM, Güler-Yüksel M, et al. Discontinuing treatment in patients with rheumatoid arthritis in sustained clinical remission: exploratory analyses from the BeSt study. Ann Rheum Dis 2011; 70: 315-319.
30.
Goekoop-Ruiterman YP, Huizinga TW, et al. Rheumatoid arthritis: can we achieve true drug-free remission in patients with RA? Nat Rev Rheumatol 2010; 6: 68-70.
31.
van der Kooij SM, Goekoop-Ruiterman YP, de Vries-Bouwstra JK, et al. Drug-free remission, functioning and radiographic damage after 4 years of response-driven treatment in patients with recent-onset rheumatoid arthritis. Ann Rheum Dis 2009; 68: 914-921.
32.
Vincent FB, Morand EF, Murphy K, et al. Antidrug antibodies (ADAb) to tumour necrosis factor (TNF)-specific neutralising agents in chronic inflammatory diseases: a real issue, a clinical perspective. Ann Rheum Dis 2013; 72: 165-178.
33.
Wolbink GJ, Vis M, Lems W, et al. Development of antiinfliximab antibodies and relationship to clinical response in patients with rheumatoid arthritis. Arthritis Rheum 2006; 54: 711-715.
34.
Wolbink GJ, Aarden LA, Dijkmans BA, et al. Dealing with immunogenicity of biologicals: assessment and clinical relevance. Curr Opin Rheumatol 2009; 21: 211-215.
35.
Garceˆs S, Antunes M, Benito-Garcia E, et al. A preliminary algorithm introducing immunogenicity assessment in the management of patients with RA receiving tumour necrosis factor inhibitor therapies. Ann Rheum Dis 2013 [Epub].
36.
van der Maas A, Kievit W, van den Bemt BJ, et al. Down-titration and discontinuation of infliximab in rheumatoid arthritis patients with stable low disease activity and stable treatment: an observational cohort study. Ann Rheum Dis 2012; 71: 1849-1854.
37.
Boumans MJ, Vos K, Gerlag DM, Tak PP. Biological treatment of rheumatoid arthritis: towards a more cost-effective re-treatment regimen using rituximab? Ann Rheum Dis 2012; 71: 472-473.
38.
Cronstein BN. Pharmacogenetics in the rheumatic diseases, from preˆt-a`-porter to haute couture. Nat Clin Pract Rheumatol 2006; 2: 2-3.
39.
Szekanecz Z. Personalized medicine in rheumatology [Hungarian]. Orv Hetil (Hung Med J) 2013; 154: 483-496.
40.
Emery P, Dorner T. Optimising treatment in rheumatoid arthritis: a review of potential biological markers of response. Ann Rheum Dis 2011; 70: 2063-2070.
41.
Isaacs JD, Cohen SB, Emery P, et al. Effect of baseline rheumatoid factor and anticitrullinated peptide antibody serotype on rituximab clinical response: a meta-analysis. Ann Rheum Dis 2012; 72: 329-336.
42.
Váncsa A, Szabó Z, Szamosi S, et al. Long-term effects of rituximab on B-cell counts and autoantibody production in rheumatoid arthritis: use of high-sensitivity flow-cytometry for more sensitive assessment of B-cell depletion. J Rheumatol 2013; 40: 565-571.
43.
Thurlings RM, Vos K, Wijbrandts CA, et al. Synovial tissue response to rituximab: mechanism of action and identification of biomarkers of response. Ann Rheum Dis 2008; 67: 917-925.
44.
Kurkó J, Besenyei T, Laki J, et al. Genetics of rheumatoid arthritis – a comprehensive review. Clin Rev Allergy Immunol 2013 [Epub].
45.
Szekanecz Z, Meskó B, Poliska S, et al. Pharmacogenetics and pharmacogenomics in rheumatology. Immunol Res 2013; 56: 325-333.
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.
Share
RELATED ARTICLE
| eISSN: | 2084-9834 |
| ISSN: | 0034-6233 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
