Switching Arthritis Drugs Can Improve Response

Switching to Remicade (infliximab) after a poor response with Enbrel (etanercept) can improve outcomes for rheumatoid arthritis patients, according to the results of a small study reported in The Journal of Rheumatology.

Switching to Remicade (infliximab) after a poor response with Enbrel (etanercept) can improve outcomes for rheumatoid arthritis patients, according to the results of a small study reported in The Journal of Rheumatology. Both drugs belong to a class of medications called tumor necrosis factor (TNF) inhibitors that work by limiting inflammation. “I do not want people to infer that (Remicade) is therapeutically superior to (Enbrel), but that switching TNF inhibitors can offer better disease control when the first drug does not fully control symptoms and signs of rheumatoid arthritis,” lead author Dr. Karen E. Hansen, from Veterans Hospital in Madison, Wisconsin, told Reuters Health. Hansen and colleagues compared the responses of 20 rheumatoid arthritis patients switching from Enbrel to Remicade with those of 73 patients receiving Remicade with no prior TNF inhibitor therapy. Both groups experienced significant improvements in a variety of disease measures, the authors report, with no major difference between the groups. Infection rates, hospital admissions, and treatment reactions were also similar for the two groups, the researchers note. A patient with an incomplete response to one TNF inhibitor may achieve better disease control with another, Hansen said. “Much remains to be learned about” how these drugs work, writes Dr. Boulos Haraoui from Hopital Notre-Dame du CHUM in Montreal, in a related editorial. “Such knowledge will help us use anti-TNF agents in a more efficient manner,” Haraoui continued. “Until predictors of response have been identified, use of these agents will be governed by clinical judgment and accumulated experience.” (Source: Reuters Health, Journal of Rheumatology, June 2004)