Biological treatment failure in adult rheumatoid arthritis, why? what is next?

الملخص EN

Objectives : to assess duration of treatment with Infliximab / Etanercept in a cohort of our RA patients and find out reasons for discontinuation of Infliximab / Etanercept in this cohort.

To identify the nature and frequency of the adverse reaction resulting in Infliximab / Etanercept discontinuation.

To identify if possible factors associated with failure of therapy.

To find out an alternatives to those who failed Infliximab / Etanercept treatment.

Subjects: Patients who were identified in our data base as having commenced and subsequently ceased Infliximab or / and Etanercept were included in our study.

Twenty Patients failed the biological treatment (16 women, 4 men ; mean age 54.5 years with a range from 21 to 74 years) has been included.

Conclusion : Anti-TNF medication should be more targeted in administration and withdrawal.

Patients who fail to respond to one TNF-alpha antagonist can respond to the other antagonist.

Furthermore, there appears to be no contraindication to using one TNF-alpha antagonist for patients who have developed hypersensitivity reactions to the other.

The side-effects observed in our study were generally mild and did not necessarily recur with the use of the second antagonist.

Further studies are needed to find out an alternative to DAS such as SDAI (simplified disease activity index).