Abstract
It has been found that tumour necrosis factor(TNF)-alpha plays a pivotal role in the pathogenesis of rheumatoid arthritis (RA), and the development of drugs targeting this molecule has extended the therapeutical approaches to RA patients. A number of observational studies of large patient series have also been published over the last few years, many of which have been based on national registries designed to monitor the efficacy and safety of anti-TNF agents, and allow healthcare institutions to control expenditure. Registry data can also help in identifying clinical and laboratory findings capable of predicting response. It has been suggested that the percentage of responding patients is lower in everyday clinical practice than that observed in RCTs, possibly because of patient selection, the use of a washout period before inclusion (which may artificially increase disease activity), and differences in doses, co-morbidities and adherence to therapy. A number of safety concerns have been raised since the introduction of anti-TNF agents, and they are now contraindicated in patients with advanced heart failure; however, the most widely debated current issues regard infections and neoplastic diseases. Moreover, the marketing of new and expensive biological agents has made strictly necessary to create systems capable of monitoring their safety and effectiveness in everyday practice, including the use of longitudinal observational studies. As the first published registry of anti-TNFα-treated patients in Italy, Lombardy Rheumatology Network (LORHEN) is already making its contribution in this direction.
| Original language | English |
|---|---|
| Pages (from-to) | 274-280 |
| Number of pages | 7 |
| Journal | Autoimmunity Reviews |
| Volume | 8 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jan 2009 |
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Keywords
- Anti-tumour necrosis factor (TNF)
- Disease modifying anti-rheumatic drugs (DMARDs)
- Methotrexate (MTX)
- Rheumatoid arthritis (RA)
ASJC Scopus subject areas
- Immunology
- Immunology and Allergy
Cite this
Treatment of rheumatoid arthritis with anti-TNF-alpha agents : A reappraisal. / Caporali, Roberto; Pallavicini, Francesca Bobbio; Filippini, Matteo; Gorla, Roberto; Marchesoni, Antonio; Favalli, Ennio Giulio; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola; Montecucco, Carlomaurizio.
In: Autoimmunity Reviews, Vol. 8, No. 3, 01.2009, p. 274-280.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of rheumatoid arthritis with anti-TNF-alpha agents
T2 - A reappraisal
AU - Caporali, Roberto
AU - Pallavicini, Francesca Bobbio
AU - Filippini, Matteo
AU - Gorla, Roberto
AU - Marchesoni, Antonio
AU - Favalli, Ennio Giulio
AU - Sarzi-Puttini, Piercarlo
AU - Atzeni, Fabiola
AU - Montecucco, Carlomaurizio
PY - 2009/1
Y1 - 2009/1
N2 - It has been found that tumour necrosis factor(TNF)-alpha plays a pivotal role in the pathogenesis of rheumatoid arthritis (RA), and the development of drugs targeting this molecule has extended the therapeutical approaches to RA patients. A number of observational studies of large patient series have also been published over the last few years, many of which have been based on national registries designed to monitor the efficacy and safety of anti-TNF agents, and allow healthcare institutions to control expenditure. Registry data can also help in identifying clinical and laboratory findings capable of predicting response. It has been suggested that the percentage of responding patients is lower in everyday clinical practice than that observed in RCTs, possibly because of patient selection, the use of a washout period before inclusion (which may artificially increase disease activity), and differences in doses, co-morbidities and adherence to therapy. A number of safety concerns have been raised since the introduction of anti-TNF agents, and they are now contraindicated in patients with advanced heart failure; however, the most widely debated current issues regard infections and neoplastic diseases. Moreover, the marketing of new and expensive biological agents has made strictly necessary to create systems capable of monitoring their safety and effectiveness in everyday practice, including the use of longitudinal observational studies. As the first published registry of anti-TNFα-treated patients in Italy, Lombardy Rheumatology Network (LORHEN) is already making its contribution in this direction.
AB - It has been found that tumour necrosis factor(TNF)-alpha plays a pivotal role in the pathogenesis of rheumatoid arthritis (RA), and the development of drugs targeting this molecule has extended the therapeutical approaches to RA patients. A number of observational studies of large patient series have also been published over the last few years, many of which have been based on national registries designed to monitor the efficacy and safety of anti-TNF agents, and allow healthcare institutions to control expenditure. Registry data can also help in identifying clinical and laboratory findings capable of predicting response. It has been suggested that the percentage of responding patients is lower in everyday clinical practice than that observed in RCTs, possibly because of patient selection, the use of a washout period before inclusion (which may artificially increase disease activity), and differences in doses, co-morbidities and adherence to therapy. A number of safety concerns have been raised since the introduction of anti-TNF agents, and they are now contraindicated in patients with advanced heart failure; however, the most widely debated current issues regard infections and neoplastic diseases. Moreover, the marketing of new and expensive biological agents has made strictly necessary to create systems capable of monitoring their safety and effectiveness in everyday practice, including the use of longitudinal observational studies. As the first published registry of anti-TNFα-treated patients in Italy, Lombardy Rheumatology Network (LORHEN) is already making its contribution in this direction.
KW - Anti-tumour necrosis factor (TNF)
KW - Disease modifying anti-rheumatic drugs (DMARDs)
KW - Methotrexate (MTX)
KW - Rheumatoid arthritis (RA)
UR - http://www.scopus.com/inward/record.url?scp=58749116632&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58749116632&partnerID=8YFLogxK
U2 - 10.1016/j.autrev.2008.11.003
DO - 10.1016/j.autrev.2008.11.003
M3 - Article
C2 - 19017546
AN - SCOPUS:58749116632
VL - 8
SP - 274
EP - 280
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
SN - 1568-9972
IS - 3
ER -