Rotation or Change of Biotherapy After First Anti-TNF Treatment Failure for Rheumatoid Arthritis

Conditions

Rheumatoid Arthritis

Keywords

Rheumatoid arthritis with inadequate response to 1 anti-TNF

Brief summary

Approximately 30% of patients with rheumatoid arthritis have an inadequate response to anti-TNF (primarily or loss of response), leaving two alternatives: rotation to a second anti-TNF or change of biologic, with a different mechanism of action, such as abatacept, rituximab and tocilizumab. No controlled trial compared these two strategies face to face. The present objective is to investigate the issue whether one of these strategies could have a better efficacy in a pragmatic trial in the setting of current practice.

Nguyen MVC, Courtier A, Adrait A, Defendi F, Couté Y, Baillet A, Guigue L, Gottenberg JE, Dumestre-Pérard C, Brun V, Gaudin P.

2020-03-243 citations

10.1007/s10067-020-05030-6

Comparative effect of tumour necrosis factor inhibitors versus other biological agents on cardiovascular risk-associated biomarkers in patients with rheumatoid arthritis

Alexandre Virone, Jean‐Philippe Bastard, Soraya Fellahi, Jacqueline Capeau, Stéphanie Rouanet et al. (10 authors)

RMD Open2019-07-0120 citations

10.1136/rmdopen-2019-000897

Serum IL-33 level is associated with auto-antibodies but not with clinical response to biologic agents in rheumatoid arthritis.

Rivière E, Sellam J, Pascaud J, Ravaud P, Gottenberg JE, Mariette X.

2018-06-086 citations

10.1186/s13075-018-1628-6

Non–TNF-Targeted Biologic vs a Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug

Jacques-Eric Gottenberg, Olivier Brocq, Aleth Perdriger, S Lassoued, Jean-Marie Berthelot et al. (47 authors)

JAMA2016-09-20185 citations

10.1001/jama.2016.13512

Interventions

DRUGinfliximab, etanercept, adalimumab

DRUGabatacept, rituximab or tocilizumab

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Active and erosive rheumatoid arthritis with a DAS28 equal or greater than 3.2 * Inadequate response to a 1st anti-TNF * Stable or no treatment with any DMARDs, or oral corticosteroids (\< or = to 10 mg/day of prednisone equivalent)during the preceding month

Exclusion criteria

* Counter-indication to other anti-TNF, abatacept, rituximab or tocilizumab * Pregnancy * Age \< 18 years * Impossibility to give informed consent * Impossibility to be followed for 12 months

Design outcomes

Primary

Measure	Time frame
Proportion of EULAR responders	6 months

Countries

France, Monaco

Contacts

PRINCIPAL_INVESTIGATORJacques-Eric GOTTENBERG, MD, PhD

Hôpitaux Universitaires de Strasbourg

Outcome results

None listed