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Comparative effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the treatment of rheumatoid arthritis

Narváez García, Francisco Javier ; Díaz-Torné, César ; Magallares, Berta ; Hernández Miguel, María Victoria ; Reina, Delia ; Corominas, Héctor ; Sanmartí Sala, Raimon ; Rodríguez de la Serna, Arturo ; Llobet, Josep Maria ; Nolla Solé, Joan Miquel

Public Library of Science (PLoS) 2015-04

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  • Título:
    Comparative effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the treatment of rheumatoid arthritis
  • Autor: Narváez García, Francisco Javier ; Díaz-Torné, César ; Magallares, Berta ; Hernández Miguel, María Victoria ; Reina, Delia ; Corominas, Héctor ; Sanmartí Sala, Raimon ; Rodríguez de la Serna, Arturo ; Llobet, Josep Maria ; Nolla Solé, Joan Miquel
  • Assuntos: Anticossos monoclonals ; Artritis reumatoide ; Drug interactions ; Drug side effects ; Drugs ; Efectes secundaris dels medicaments ; Interaccions dels medicaments ; Medicaments ; Methotrexate ; Metotrexat ; Monoclonal antibodies ; Rheumatoid arthritis
  • Notas: PLoS One, 2015, vol. 10, num. 4, p. e0123392
    https://doi.org/10.1371/journal.pone.0123392
    Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0123392
    Articles publicats en revistes (Ciències Clíniques)
    1932-6203
    http://hdl.handle.net/2445/111111
    25830224
    654759
  • Descrição: Objective: In agreement with EULAR recommendations, a DMARD in combination with a biotherapy is the reference treatment because of the superior long-term clinical and radiographic outcomes. Methotrexate (MTX) is the cornerstone of combination therapy but is in some cases contra-indicated or poorly tolerated. This observational study aimed to compare the effectiveness and safety of TCZ in combination with either MTX or leflunomide (LEF) in the treatment of patients with active rheumatoid arthritis (RA) and an inadequate response to one or more DMARDs and/or biological agents in a real-world setting. Methods: We performed an ambispective review of 91 patients with active RA who were routinely treated with TCZ plus MTX or LEF. A comparative study between the two combinations of treatment was performed at 6 months of follow-up considering 3 outcomes: improvement of RA disease activity, evolution of functional disability, and tolerability and side effect profile. Results: Of the 91 patients, 62 received TCZ with MTX and 29 received TCZ with LEF. Eighty-one patients were followed for 6 months, and the remaining 10 patients discontinued treatment due to serious adverse events. At baseline, there were no significant differences between the groups in terms of the main clinical and laboratory data or in the number of previous DMARDs and biological agents used. At 6 months, there were no significant differences between the combinations in terms of disease activity and functional disability. Serious adverse events occurred in 11% and 10% of the patients treated in combination with MTX and LEF, respectively. Conclusion: Our preliminary data support the argument that LEF is an effective and safe (equivalent) alternative to MTX for combination treatment with TCZ.
  • Editor: Public Library of Science (PLoS)
  • Data de criação/publicação: 2015-04
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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