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Lack of adverse effect of anti‐tumor necrosis factor‐α biologics in treatment of rheumatoid arthritis: 5 years follow‐up
Author(s) -
Dewedar Ahmed M.,
Shalaby Medhat A.,
AlHomaid Sulaiman,
Mahfouz Ahmed M.,
Shams Osama A.,
Fathy Ahmed
Publication year - 2012
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2012.01715.x
Subject(s) - medicine , adalimumab , etanercept , infliximab , rheumatoid arthritis , adverse effect , golimumab , tnf inhibitor , tumor necrosis factor alpha , surgery , gastroenterology
Background Rheumatoid arthritis ( RA ) is a chronic, systemic inflammatory disorder affecting synovial joints and many other organs. Most patients seen in clinical settings have a progressive chronic disease, with radiographic damage, frequent work disability, incremental functional declines and increased mortality rates. The introduction of the biological drugs in treatment of RA has played an important role in prevention of destructive effects of the disease but may have serious adverse effects due to their powerful inhibition of the immune system. Objectives To study the adverse effects ( ADE s) of three different tumor necrosis factor α inhibitor ( TNF i) drugs (infliximab, adalimumab and etanercept) in RA patients for 5 years in the south‐west area of S audi A rabia. Methods Two groups of RA patients were included in this study: The first group included 112 patients, representing the biologics group. These patients received biological therapy plus disease modifying anti‐rheumatic drugs ( DMARD s): 56 patients received infliximab ( IFX ), 36 patients received adalimumab ( ADL ) and 20 patients received etanercept ( ETN ). The second group also included 112 patients, representing the control group: RA patients treated only with the traditional DMARD s. ADE s were classified into mild and severe. Results The mild ADE s which had been recorded during 5 years of follow‐up in patients receiving TNF i, were onycholysis (1.8%), positive tuberculin test (1.8%) and small vessel vasculitis (1.8%). Statistically, there were insignificant differences in the mild ADE s except for upper respiratory tract infection that was significantly higher in the control group. Severe ADE s included pneumonia (1.8%) and solid tumor (1.8%) and there were no significant differences between the biologics and control groups. Also there were no significant statistical differences for the ADE s, mild or severe, between the three biologics, infliximab, adalimumab and etanercept. Occurrence of ADE s did not correlate to methotrexate dose, steroid dose or rheumatoid factor positivity. Conclusions Our results indicate that the use of TNF i therapy appeared to be as safe as traditional DMARD s in treatment of rheumatoid arthritis patients and long‐term follow‐up with careful examination is essential to pick up any abnormal ADE s.