EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG

Objective: to analyze the relationship of the clinical and antidestructive effect of infliximab (INF) to its total dose in patients with rheumatoid arthritis (RA).Subjects and methods. A one-year investigation included 135 patients with RA. All patients received INF 3 mg/kg at weeks 0, 2, 4 and then...

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Main Authors: E. S. Aronova, G. V. Lukina, Ya. A. Sigidin
Format: Article
Language:Russian
Published: IMA PRESS LLC 2015-10-01
Series:Научно-практическая ревматология
Subjects:
Online Access:https://rsp.mediar-press.net/rsp/article/view/2128
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author E. S. Aronova
G. V. Lukina
Ya. A. Sigidin
author_facet E. S. Aronova
G. V. Lukina
Ya. A. Sigidin
author_sort E. S. Aronova
collection DOAJ
description Objective: to analyze the relationship of the clinical and antidestructive effect of infliximab (INF) to its total dose in patients with rheumatoid arthritis (RA).Subjects and methods. A one-year investigation included 135 patients with RA. All patients received INF 3 mg/kg at weeks 0, 2, 4 and then every 8 weeks. During each visit, the number of tender and swollen joints, C-reactive protein level, and erythrocyte sedimentation rate were determined and the Health Assessment Questionnaire (HAQ) was filled out. DAS-28 changes were used to assess therapeutic effect of INF. Joint destruction was evaluated by the Sharp method modified by van der Heijde. All patients were examined according to the protocol before each INF infusion. The result of INF therapy was assessed at week 54 in all patients (including in those who had not completed a one-year INF therapy cycle). According to the total dose of INF, the patients were divided into three groups: 1) ≤4 infusions (low-dose, n = 63); 2) 5–7 infusions (medium-dose, n = 31); 3) ≥8 infusions (full-dose, n = 41). Group 1 received an average of 2.5 IFN infusions; Group 2 and 3 – 5.8 and 8.8 infusions, respectively.Results. Baseline high disease activity (DAS28 > 5.1) was noted in the majority of the patients: 69% in Group 1, 86.6% in Group 2, and 62.1% in Group 3. All the patients showed a prompt (just at 14 weeks of treatment) and significant (p < 0.05) decrease of RA activity. This reduction remained significant at week 54. By the end of follow-up there were more patients with low disease activity (including those with DAS28 remission) in Group 3 than the other groups (53.9% versus 27.3 and 50% in Groups 1 and 2, respectively). After the completion of therapy, the highest percentage of patients with high disease activity was seen in Group 1 (36.4%). The number of remissions was comparable in Groups 2 and 3 (28.6 and 23.1%, respectively) and smaller in Group 1 (18.2%). Significantly more obvious radiographic disease progression was noted in Group 1 than in the two other groups.Conclusion. The lower total dose of INF can cause a long-lasting clinical effect in some patients with RA, but it does not substantially suppress joint destruction. There were no significant differences between patients receiving medium and full doses of this drug in and the degree of radiographic disease progression.
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spelling doaj.art-595ca007e79741c897e1272c702d593d2023-03-22T13:45:50ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922015-10-0153550651110.14412/1995-4484-2015-506-5112011EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUGE. S. Aronova0G. V. Lukina1Ya. A. Sigidin2V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522Objective: to analyze the relationship of the clinical and antidestructive effect of infliximab (INF) to its total dose in patients with rheumatoid arthritis (RA).Subjects and methods. A one-year investigation included 135 patients with RA. All patients received INF 3 mg/kg at weeks 0, 2, 4 and then every 8 weeks. During each visit, the number of tender and swollen joints, C-reactive protein level, and erythrocyte sedimentation rate were determined and the Health Assessment Questionnaire (HAQ) was filled out. DAS-28 changes were used to assess therapeutic effect of INF. Joint destruction was evaluated by the Sharp method modified by van der Heijde. All patients were examined according to the protocol before each INF infusion. The result of INF therapy was assessed at week 54 in all patients (including in those who had not completed a one-year INF therapy cycle). According to the total dose of INF, the patients were divided into three groups: 1) ≤4 infusions (low-dose, n = 63); 2) 5–7 infusions (medium-dose, n = 31); 3) ≥8 infusions (full-dose, n = 41). Group 1 received an average of 2.5 IFN infusions; Group 2 and 3 – 5.8 and 8.8 infusions, respectively.Results. Baseline high disease activity (DAS28 > 5.1) was noted in the majority of the patients: 69% in Group 1, 86.6% in Group 2, and 62.1% in Group 3. All the patients showed a prompt (just at 14 weeks of treatment) and significant (p < 0.05) decrease of RA activity. This reduction remained significant at week 54. By the end of follow-up there were more patients with low disease activity (including those with DAS28 remission) in Group 3 than the other groups (53.9% versus 27.3 and 50% in Groups 1 and 2, respectively). After the completion of therapy, the highest percentage of patients with high disease activity was seen in Group 1 (36.4%). The number of remissions was comparable in Groups 2 and 3 (28.6 and 23.1%, respectively) and smaller in Group 1 (18.2%). Significantly more obvious radiographic disease progression was noted in Group 1 than in the two other groups.Conclusion. The lower total dose of INF can cause a long-lasting clinical effect in some patients with RA, but it does not substantially suppress joint destruction. There were no significant differences between patients receiving medium and full doses of this drug in and the degree of radiographic disease progression.https://rsp.mediar-press.net/rsp/article/view/2128infliximabadverse reactionsrheumatoid arthritisradiographic progression
spellingShingle E. S. Aronova
G. V. Lukina
Ya. A. Sigidin
EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
Научно-практическая ревматология
infliximab
adverse reactions
rheumatoid arthritis
radiographic progression
title EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
title_full EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
title_fullStr EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
title_full_unstemmed EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
title_short EFFICACY OF INFLIXIMAB IN RHEUMATOID ARTHRITIS: A RELATIONSHIP TO THE TOTAL DOSE OF THE DRUG
title_sort efficacy of infliximab in rheumatoid arthritis a relationship to the total dose of the drug
topic infliximab
adverse reactions
rheumatoid arthritis
radiographic progression
url https://rsp.mediar-press.net/rsp/article/view/2128
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