A New Chance to Maintain Remission Induced by Anti-TNF Agents in Rheumatoid Arthritis Patients: CynAR Study II of a 12-Month Follow-up

The advent of biological therapies represented the beginning of a new era in the therapy of Rheumatoid Arthritis (RA), as demonstrated in several studies, but still many questions about their safety, especially in long term use, and correct administration time remain unanswered. Once remission is ac...

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Published in:International journal of immunopathology and pharmacology 2011-01, Vol.24 (1), p.167-174
Main Authors: Migliore, A., Bizzi, E., Massafra, U., Vacca, F., Martin, L.S. Martin, Ferlito, C., Podestà, E., Granata, M., Laganà, B.
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - drug therapy
Cyclosporine - administration & dosage
Drug Therapy, Combination
Female
Humans
Male
Methotrexate - administration & dosage
Middle Aged
Prospective Studies
Tumor Necrosis Factor-alpha - antagonists & inhibitors
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cited_by cdi_FETCH-LOGICAL-c342t-c960b4395251e5a043885ac8197345c0b1196c068bd33e0dd5610cba07bbd0e33
cites cdi_FETCH-LOGICAL-c342t-c960b4395251e5a043885ac8197345c0b1196c068bd33e0dd5610cba07bbd0e33
container_end_page 174
container_issue 1
container_start_page 167
container_title International journal of immunopathology and pharmacology
container_volume 24
creator Migliore, A.
Bizzi, E.
Massafra, U.
Vacca, F.
Martin, L.S. Martin
Ferlito, C.
Podestà, E.
Granata, M.
Laganà, B.
description The advent of biological therapies represented the beginning of a new era in the therapy of Rheumatoid Arthritis (RA), as demonstrated in several studies, but still many questions about their safety, especially in long term use, and correct administration time remain unanswered. Once remission is achieved, the orientation of clinicians regarding the maintenance of biological therapy or the switch to another immunosuppressive therapy is still uncertain. In our previous study 21 patients affected by RA who reached remission by the use of a combined therapy of anti-TNF drugs and methotrexate (MTX) underwent CyA-MTX combination therapy for maintaining remission state and were evaluated during a 6-month follow-up. The present study aims to investigate these data by a longer follow-up (12 months) and on a larger population. Fifty-three RA patients, with a disease duration of less than 3 years and DAS28
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The present study aims to investigate these data by a longer follow-up (12 months) and on a larger population. Fifty-three RA patients, with a disease duration of less than 3 years and DAS28&lt;3.2 that reached a level of low disease activity within 6–8 months from the beginning of anti-TNF and methotrexate therapy, were enrolled in the study. By the suspension of anti-TNF therapy, patients underwent A-Cyclosporine (2–3 mg/kg/day) and methotrexate (15mg/week) therapy. DAS28, Pain VAS, Erythrosedimentation rate (ESR), C Reactive Protein (CRP) were all tested at time 0 and every 2 months after the interruption of the anti-TNF therapy and the beginning of A-Cyclosporine and methotrexate therapy, as well as liver and kidney profiles. Side effects were also recorded. Of 53 patients, 50 completed the study with a 12-month follow-up. Twenty-one (42%) patients maintained clinical parameters within low disease activity values at 12 months, while 29 (58%) patients showed an increase in DAS28 and other parameters: 16 (32%) patients at the 6-month control, 13 (26%) patients at the 12-month control. Our data show that 42% of the patients undergoing A-Cyclosporin and Methotrexate therapy maintained low disease activity parameters of rheumatoid arthritis, obtained after 6–8 months of anti-TNF therapy. 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Once remission is achieved, the orientation of clinicians regarding the maintenance of biological therapy or the switch to another immunosuppressive therapy is still uncertain. In our previous study 21 patients affected by RA who reached remission by the use of a combined therapy of anti-TNF drugs and methotrexate (MTX) underwent CyA-MTX combination therapy for maintaining remission state and were evaluated during a 6-month follow-up. The present study aims to investigate these data by a longer follow-up (12 months) and on a larger population. Fifty-three RA patients, with a disease duration of less than 3 years and DAS28&lt;3.2 that reached a level of low disease activity within 6–8 months from the beginning of anti-TNF and methotrexate therapy, were enrolled in the study. By the suspension of anti-TNF therapy, patients underwent A-Cyclosporine (2–3 mg/kg/day) and methotrexate (15mg/week) therapy. DAS28, Pain VAS, Erythrosedimentation rate (ESR), C Reactive Protein (CRP) were all tested at time 0 and every 2 months after the interruption of the anti-TNF therapy and the beginning of A-Cyclosporine and methotrexate therapy, as well as liver and kidney profiles. Side effects were also recorded. Of 53 patients, 50 completed the study with a 12-month follow-up. Twenty-one (42%) patients maintained clinical parameters within low disease activity values at 12 months, while 29 (58%) patients showed an increase in DAS28 and other parameters: 16 (32%) patients at the 6-month control, 13 (26%) patients at the 12-month control. Our data show that 42% of the patients undergoing A-Cyclosporin and Methotrexate therapy maintained low disease activity parameters of rheumatoid arthritis, obtained after 6–8 months of anti-TNF therapy. Further studies on larger populations are necessary in order to confirm such results and identify predictor factors for different responses.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>21496399</pmid><doi>10.1177/039463201102400119</doi><tpages>8</tpages></addata></record>
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subjects Adult
Aged
Arthritis, Rheumatoid - drug therapy
Cyclosporine - administration & dosage
Drug Therapy, Combination
Female
Humans
Male
Methotrexate - administration & dosage
Middle Aged
Prospective Studies
Tumor Necrosis Factor-alpha - antagonists & inhibitors
title A New Chance to Maintain Remission Induced by Anti-TNF Agents in Rheumatoid Arthritis Patients: CynAR Study II of a 12-Month Follow-up
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