RESEARCH - TNF blockers comparable in RA treatment

[Guest guest]

TNF Blockers Comparable in RA Treatment

NEW YORK (Reuters Health) Jan 18 - The tumor necrosis factor (TNF) blocking

biologics adalimumab (Humira), infliximab (Remicade) and etanercept (Enbrel)

are broadly equivalent in treating rheumatoid arthritis (RA) in terms of

efficacy and safety, according to an analysis of pooled data.

" Overall, biologics are highly effective treatments for rheumatoid

arthritis, " lead investigator Dr. Gerald Gartlehner pointed out. " Biologics,

however, also have the potential for rare but severe side effects such as

serious infections or cancers. "

" Findings of our study, " he told Reuters Health continued, " suggest that

Humira, Enbrel, and Remicade are very similar in their effectiveness. "

However, the interleukin-1 blocker anakinra (Kineret) " appears to be less

effective than these three drugs. "

As reported in the December issue of the Journal of Rheumatology, Dr.

Gartlehner of the University of North Carolina, Chapel Hill and colleagues

studied data from 17 placebo-controlled studies involving more than 5200

patients with methotrexate-resistant RA. The researchers also took into

account a number of other trials evaluating efficacy and safety.

The finding that the tumor-necrosis factor blocking agents were more

effective than anakinra, say the investigators, is consistent with that in

other indirect comparisons.

Overall, the researchers conclude that the safety data were insufficient to

draw firm conclusion about long-term effects of biologics.

Moreover, they note, routes of administration vary. For example, adalimumab,

anakinra and etanercept can be administered subcutaneously by the patient.

Infliximab, requires an office visit every 4 to 8 weeks for an intravenous

infusion. Some patients prefer the infusion over self-administration and

vice versa.

Dr. Gartlehner therefore concluded, " Given the similar effectiveness of

Humira, Enbrel, and Remicade, decisions about the choice of a biologic for a

patient should also include patient convenience, costs, and insurance

coverage. "

J Rheumatol 2006;33:2398-2408

http://www.medscape.com/viewarticle/550961

Not an MD