Repeat Treatment with Etanercept in Patients with Rheumatoid Arthritis after Failure of Switched Biologic Therapy

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  • 生物学的製剤多剤切り替えでエタネルセプトを再投与した関節リウマチ患者の検討
  • セイブツガクテキ セイザイ タザイ キリカエ デ エタネルセプト オ サイトウヨ シタ カンセツ リウマチ カンジャ ノ ケントウ

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Abstract

Objective: The objective of this study was to investigate whether repeat treatment with the tumor necrosis factor-α (TNF-α) antagonist etanercept can be effective after the initial clinical response to this drug was lost.<br>Methods: This retrospective, observational study analyzed data from all patients with rheumatoid arthritis (RA) who were treated with etanercept at our institution between 2005 and 2009. All patients fulfilled the 1987 American College of Rheumatology (ACR) criteria for RA.<br>Results: Etanercept was initially administered to 135 patients with RA between 2005 and 2009. Twenty of these patients switched to another biological agent because of adverse events or an absence or secondary loss of efficacy. Three of these 20 patients switched to different biological agents and returned to etanercept because their initial response to etanercept was better than that to any of the others. Disease activity was high in all three patients before initial etanercept therapy and each had clinically responded by 24 weeks. However, the initial clinical effect was lost between 1.5 and 3.5 years thereafter and tocilizumab was administered, but the effect was again lost between 3 and 18 months later. Two patients did not respond to subsequent treatment with adalimumab and infliximab. Etanercept administered once again reduced disease activity in all three patients, none of whom developed any acute side effects.<br>Conclusions: Repeat administration of etanercept significantly improved clinical disease activity and inflammatory parameters in three patients with RA who were refractory to biological anti-TNF agents.

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