Is anti- TNF therapy safe for rheumatoid arthritis?
The past decade has brought important advances in understanding of rheumatoid arthritis (RA) and its management and treatment. RA is the most common autoimmune disease that affects the joints. Arthritis in general and rheumatoid arthritis in particular, is a common cause of disability. A new study has confirmed the benefits of anti-TNF therapies and more than a decade patients with RA can use them.
This new study led by the Gaetano Pini Institute in Milan, Italy revealed that about 25% of patients treated with anti-TNFs are able to remain on their initial course of treatment for at least 12 years. During study, researchers assessed the long-term drug survival for anti-TNFs (infliximab, etanercept or adalimumab) among 583 patients and compared the discontinuation rates due to these drugs. They found that lack of effectiveness of the emergence of harmful side effects were the most common reasons for withdrawl and the treatment group included 222 patients, who were treated with infliximab, 179 with etanercept and 182 with adalimumab.
The research assessed drug survival rates among 583 patients enrolled in a local registry, comparing discontinuation rates among patients treated with infliximab, etanercept or adalimumab. Moreover, the results recommended that patients who received etanercept were less likely to need to cease their treatment than those on adalimumab or infliximab. The chances of discontinuation due to ineffectiveness was stable from 3 to 12 years for etanercept, but progressively increased for other two drugs.
The study also displayed that drug survival rates for adalimumab and etanercept significantly increased at the same time when being treated with methotrexate. According to Dr Katherine Free, "Anti-TNF therapy, pioneered and developed in part due to funding from Arthritis Research UK, has transformed the treatment of people with rheumatoid arthritis and other inflammatory conditions across the globe and is an example of the huge benefits that research can bring."
"This study provides reassuring evidence that anti-TNF therapies are effective in some patients over long periods of time; however, it also highlights the importance of selecting the right drug for each patient, as a large number of people with arthritis have to switch between therapies during a course of treatment.
"We are funding research which aims to help doctors predict which patients will respond best to which therapies, helping to speed up the time it takes to get the right treatment to the right patient."