To investigate the impact of adalimumab on the biologic-naive (bio-naïve) and bio-switch rheumatoid arthritis (RA) patients, and to clarify the appropriate indications for adalimumab treatment.
The retention rate, efficacy and safety of adalimumab in twenty-one RA patients were analyzed. Fourteen of the patients were bio-naive and seven were bio-switched from other biologics. Concomitant methotrexate was used in 85% of the bio-naive and 71% of the bio-switch patients. The radiographic findings before and after the 1 year and the two years treatment were also surveyed.
In the bio-naive group, 63% of patients continued adalimumab for 2 years, and remission was achieved in approximately 50% of patients. The mean 28-joint Disease Activity Scores improved from 5.2 to 2.6. Radiographically, the joint damage did not progress in either erosions or joint space narrowing. In the bio-switch group, the retention rate was 29%, and only patients who were switched from infliximab showed responses to the treatment. Herpes zoster requiring hospitalization occurred in two cases and injection site reactions were noted in other two cases.
Adalimumab combined with methotrexate would be a useful first choice biologic regimen in bio-naïve RA patients. As a second biologic, adalimumab could be useful only when treatments are switched from infliximab.