@article{464e5a23ff9d4bf8861d254597834e08,
title = "Treatment response to a second or third TNF-inhibitor in RA: results from the South Swedish Arthritis Treatment Group Register.",
abstract = "Objectives. To study treatment response rates of RA patients undergoing second- and third-line anti-TNF therapy and to identify baseline predictors of response to second-line treatment. Methods. RA patients monitored in a prospective, observational study, having switched anti-TNF therapy once (first-time switchers, n = 337) or twice (second-time switchers, n = 36)-i.e. following failures with one antibody- and one receptor-type agent-between March 1999 and December 2006, were studied. Treatment responses at 3 months were assessed by the ACR and European League Against Rheumatism (EULAR) response criteria. Predictive potentials for response to second-line treatment of demographics, baseline disease activity measures, disease and treatment characteristics were analysed using logistic regression. Results. ACR20 response was met by 51% of first-time and 35% of second-time switchers. Corresponding ACR50 rates were 27 and 18%; EULAR overall rates (EULAR good or moderate response) 71 and 58%; EULAR good rates 25 and 9% and 28-joint disease activity score (DAS28) remission rates 16 and 6%. Identified baseline predictors of response to second-line treatment were lower age and HAQ scores, elevated DAS28 values and having ceased the former anti-TNF treatment due to adverse events rather than inefficacy. No variable was predictive for all examined response criteria. Conclusions. Response rates of first-time anti-TNF switchers are somewhat below those of anti-TNF na{\"i}ve RA patients, while the markedly inferior response rates of second-time switchers suggest other therapeutic options to be considered in this situation. Identified baseline predictors of response may be useful indicators to second-line anti-TNF therapy, but vary depending on the response criteria set studied.",
keywords = "RA, Anti-TNF, Switching, Predictors, Observational study",
author = "JA Karlsson and Kristensen, {Lars Erik} and {C Kapetanovic}, Meliha and Anders G{\"u}lfe and Tore Saxne and Pierre Geborek",
year = "2008",
doi = "10.1093/rheumatology/ken034",
language = "English",
volume = "47",
pages = "507--513",
journal = "Rheumatology",
issn = "1462-0332",
publisher = "Oxford University Press",
number = "4",
}