The Impact of Biological Drugs in Patients with Rheumatoid Arthritis
DOI:
https://doi.org/10.24950/rspmi/original/355/3/2018Keywords:
Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/drug therapy, Biological Products/therapeutic use, Etanercept, Receptors, Tumor Necrosis FactorAbstract
Introduction: Rheumatoid arthritis (RA) is a disabling autoimmune disease. Biological agents have dramatically altered the natural course of the disease. This study evaluated the impact of these drugs on patients’ lives and analyzed the factors responsible for a better response to treatment.
Material and Methods: Retrospective study of 80 patients diagnosed with RA and treated with biological drugs between January 2004 and April 2015 in Hospital Senhora de Oliveira, Guimarães (Portugal). Patients were retrospectively evaluated before and 6 months after biological treatment.
Results: A total of 80 patients with RA were analyzed, 62 women (77.5%) and 18 men (22.5%), with a mean age of 45.5 (± 13.0) years. About 67.1% of the patients were positive for rheumatoid factor and 55.4% were positive for anti-citrulline antibodies. There was an association between the positivity of these antibodies and RA diagnosis (p ≤ 0.001). Etanercept was the biological drug used in most patients (75.9%). Fifteen (18.8%) patients discontinued the biological drug and 19 (24.1%) switched to another. In 6 months of biological treatment, patients had a significant reduction in erythrocyte sedimentation rate, in C-reactive protein levels and in Disease Activity Score (DAS28), which decreased from 4.91 ± 1.31 to 2.53 ± 1.10 (p ≤ 0.001).
Discussion: The results confirm the many benefits of biological drugs in patients with RA.
Conclusion: Biological drugs significantly reduce the level of disease activity, inflammatory parameters and symptoms of patients with RA.
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References
Klippel JH, Stone JH, Crofford LJ, White PH. Primer on the Rheumatic Diseases. 13th ed. New York: Springer; 2008.
Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL LJ. Harrison’s Principles of Internal Medicine. 18th ed. Boston: McGraw- -Hill; 2012.
Ventura FS. Doenças Reumáticas. Quidnovi. 2007. O Essencial da Saúde; 8: 45-104.
Vaz AL. Artrite Reumatóide. Lisboa: Lidel; 2000.
nedai.org. Lisboa: Núcleo de Estudos das Doenças Autoimunes da Sociedade Portuguesa de Medicina Interna, Inc.; c2014-2017; [consultado
em 12 Novembro de 2016]. Disponível em: http://www.nedai.org/
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010; 69:1580-8. doi: 10.1136/ard.2010.138461.
Smolen JS, Landewé R, Breedveld F, Burmester G, Chatzidionysiou K, Dougados M, et al. EULAR recommendations for the management of
rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010; 69:964-75. doi: 10.1136/ ard.2009.126532.
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:S1. doi: 10.1186/ar2666.
Marchesoni A, Zaccara E, Gorla R, Bazzani C, Sarzi-Puttini P, Atzeni F, et al. TNF-α antagonist survival rate in a cohort of rheumatoid arthritis patients observed under conditions of standard clinical practice. Ann N Y Acad Sci. 2009; 1173: 837-46. . doi: 10.1111/j.1749-6632.2009.04621.x.
Kline RB. Principles and Practice of Structural Equation Modeling. New York: Guilford Press; 2005.
Pereira A, Patrício T. SPSS Guia Prático de Utilização. 8ª ed. Lisboa: edições Sílabo; 2013.
Smolen JS, Landewé R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014 ;73:492-509. doi: 10.1136/ annrheumdis-2013-204573.
Rudolf M, Deighton C, Bosworth A, Hall J, Hammond A, Hennell S, et al. Rheumatoid arthritis: the management of rheumatoid arthritis in adults. NICE clinical guideline 2009. [accessed Nov 2017] Available from: https://www.nice.org.uk/guidance/cg79/resources/rheumatoid-arthritis-in-adults-management-pdf-975636823525
Emery P, Sebba A, Huizinga T. Biologic and oral disease-modifying antirheumatic drug monotherapy in rheumatoid arthritis. Ann Rheum Dis. 2013; 72:1897-904. doi: 10.1136/annrheumdis-2013-203485
Saag K, Teng G, Patkar N, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 Recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008; 59: 762-84. doi: 10.1002/art.23721.
Schellekens G, Visser H, de Jong B, van den Hoogen FH, Hazes JM, Breedveld FC, et al. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum. 2000; 43: 155-63.
O'Dell JR, Mikuls T, Taylor T, Ahluwalia V, Brophy M, Warren S, et al. Therapies for active rheumatoid arthritis after methotrexate failure. N Engl J Med. 2013; 69:307-18. doi: 10.1056/NEJMoa1303006.
Jacoby R, Cosh J, Jayson M. Onset, early stages, and prognosis of rheumatoid arthritis: a clinical study with 100 patients with 11 years of follow-up. Br Med J. 1973; 2: 96-100.
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