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首页> 外文期刊>Rheumatology >Efficacy in current practice of switching between anti-tumour necrosis factor- alpha agents in spondyloarthropathies.
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Efficacy in current practice of switching between anti-tumour necrosis factor- alpha agents in spondyloarthropathies.

机译：在脊椎关节病的抗肿瘤坏死因子-α药物之间进行切换的当前实践中的功效。

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OBJECTIVE: Anti-TNF-alpha agents are remarkably effective in the treatment of SpAs. However, 30% of patients withdraw from anti-TNF-alpha agents yearly because of inadequate efficacy or side effects. The objective of this study was to assess in current practice the response to a second and a third anti-TNF-alpha. METHODS: Retrospectively, all records of patients who had received at least two anti-TNF-alpha agents have been studied. For axial forms, treatment was considered effective if 3 months after switching the patient had a favourable expert opinion or showed an improvement in BASDAI of at least 2 on a scale of 0-10 or an improvement of 50% (BASDAI 50). For peripheral forms, the treatment was considered effective if the patient had a favourable expert opinion or if a clinical improvement of >30% of the swollen and tender joint counts was established. The reasons for switching were: (i) primary non-responder; (ii) loss of efficacy; and (iii) occurrence of side effects. To identify response predictor factors bivariate analysis was performed. RESULTS: Three hundred and seventy-seven patients under anti-TNF-alpha agents were treated and 99 patients had received at least two anti-TNF-alpha agents. Twenty-eight of these 99 patients had been treated with three anti-TNF-alpha agents. Following the failure of a first anti-TNF-alpha, the response to a second agent was satisfactory in 80.8%. Patients who had received a third anti-TNF-alpha following failure of the first two also showed a satisfactory response in 82.1%. The reason for switching from the first or second agent was not predictive of the response. CONCLUSION: In the event of failure or intolerance to anti-TNF-alpha in the treatment of SpAs, performing a first or second switch produces a satisfactory therapeutic response.
机译：目的：抗TNF-α剂在SpA的治疗中非常有效。但是，由于疗效或副作用不足，每年有30％的患者退出抗TNF-α药物治疗。这项研究的目的是评估当前实践中对第二种和第三种抗TNF-α的反应。方法：回顾性地，研究了接受至少两种抗TNF-α药物的患者的所有记录。对于轴突形式，如果患者转诊3个月后，专家意见良好或BASDAI改善至少2倍（0-10）或改善50％（BASDAI 50），则认为治疗有效。对于周围形式，如果患者有专家意见，或者临床肿胀和触痛计数超过30％，则认为该治疗有效。转换的原因是：（i）主要无响应者; （ii）失去功效; （iii）发生副作用。为了确定反应预测因子，进行了双变量分析。结果：接受抗TNF-α药物治疗的377例患者中，有99例接受了至少两种抗TNF-α药物的治疗。在这99名患者中，有28名接受了三种抗TNF-α药物的治疗。在第一种抗TNF-α失败后，对第二种药物的反应令人满意，达到80.8％。在前两次失败后接受第三次抗TNF-α治疗的患者也显示出满意的缓解率，为82.1％。从第一或第二代理切换的原因不能预测响应。结论：如果在SpA治疗中对抗TNF-α失败或不耐受，进行第一或第二次转换可产生令人满意的治疗反应。

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