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Short interruptions of TNF-inhibitor treatment can be associated with treatment failure in patients with immune-mediated diseases.
Lamberg, Tea; Sipponen, Taina; Valtanen, Sanna; Eklund, Kari K; Mälkönen, Tarja; Aalto, Kristiina; Mikola, Katriina; Kolho, Kaija-Leena; Leinonen, Sanna; Isomäki, Pia; Mäkinen, Heidi; Vidqvist, Krista-Liisa; Kokko, Arto; Huilaja, Laura; Kyllönen, Minna; Keskitalo, Paula; Sard, Sirja; Vähäsalo, Paula; Koskela, Ritva; Kröger, Liisa; Lahtinen, Perttu; Haapala, Anna-Maija; Korkatti, Katja; Sokka-Isler, Tuulikki; Jokiranta, T Sakari.
Afiliación
  • Lamberg T; United Medix Laboratories, Helsinki, Finland.
  • Sipponen T; Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Valtanen S; Department of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Eklund KK; United Medix Laboratories, Helsinki, Finland.
  • Mälkönen T; Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Aalto K; Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Mikola K; Orton Orthopedic Hospital Helsinki, Helsinki, Finland.
  • Kolho KL; Department of Dermatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Leinonen S; New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Isomäki P; New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Mäkinen H; Pediatric Gastroenterology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Vidqvist KL; Tays Eye Centre, Tampere University Hospital, Tampere, Finland.
  • Kokko A; Centre for Rheumatology, Tampere University Hospital, Tampere, Finland.
  • Huilaja L; Centre for Rheumatology, Tampere University Hospital, Tampere, Finland.
  • Kyllönen M; Centre for Rheumatology, Tampere University Hospital, Tampere, Finland.
  • Keskitalo P; Department of Rheumatology, Jyväskylä Central Hospital, Jyväskylä, Finland.
  • Sard S; PEDEGO Research Unit, University of Oulu, Oulu, Finland.
  • Vähäsalo P; Department of Dermatology and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Koskela R; Department of Rheumatology, Oulu University Hospital, Oulu, Finland.
  • Kröger L; PEDEGO Research Unit, University of Oulu, Oulu, Finland.
  • Lahtinen P; Department of Pediatrics, Oulu University Hospital, Oulu, Finland.
  • Haapala AM; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Korkatti K; PEDEGO Research Unit, University of Oulu, Oulu, Finland.
  • Sokka-Isler T; Department of Pediatrics, Oulu University Hospital, Oulu, Finland.
  • Jokiranta TS; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
Autoimmunity ; 55(5): 275-284, 2022 08.
Article en En | MEDLINE | ID: mdl-35481450
INTRODUCTION: The prevalence of immune-mediated diseases has increased in the past decades and despite the use of biological treatments all patients do not achieve remission. The aim of this study was to characterise the reasons for short interruptions during treatment with two commonly used TNF-inhibitors infliximab and adalimumab and to analyse the possible effects of the interruptions on immunisation and switching the treatment. MATERIAL AND METHODS: This case-control study was based on retrospective analyses of patient records and a questionnaire survey to clinicians. A total of 370 patients (194 immunised cases and 172 non-immunised controls, 4 excluded) were enrolled from eight hospitals around Finland. Eleven different diagnoses were represented, and the largest patient groups were those with inflammatory bowel or rheumatic diseases. RESULTS: Treatment interruptions were associated with immunisation in patients using infliximab (p < .001) or adalimumab (p < .000001). Patients with treatment interruptions were more likely to have been treated with more than one biological agent compared to those without treatment interruptions. This was particularly prominent among patients with a rheumatic disease (p < .00001). The most frequent reason for a treatment interruption among the cases was an infection, whereas among the control patients it was remission. The median length of one interruption was one month (interquartile range 1-3 months). CONCLUSION: Our results suggest that the interruptions of the treatment with TNF-inhibitors expose patients to immunisation and increase the need for drug switching. These findings stress the importance of careful judgement of the need for a short interruption in the biological treatment in clinical work, especially during non-severe infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Reumáticas / Inhibidores del Factor de Necrosis Tumoral Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Autoimmunity Asunto de la revista: ALERGIA E IMUNOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Reumáticas / Inhibidores del Factor de Necrosis Tumoral Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Autoimmunity Asunto de la revista: ALERGIA E IMUNOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido