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Title: Comparative effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the treatment of rheumatoid arthritis
Author: Narváez García, Francisco Javier
Díaz-Torné, César
Magallares, Berta
Hernández, Maria Victoria
Reina, Delia
Corominas, Héctor
Sanmartí Sala, Raimon
Rodriguez de la Serna, Arturo
Llobet, Josep Maria
Nolla Solé, Joan Miquel
Keywords: Anticossos monoclonals
Artritis reumatoide
Efectes secundaris dels medicaments
Interaccions dels medicaments
Monoclonal antibodies
Rheumatoid arthritis
Drug side effects
Drug interactions
Issue Date: 1-Apr-2015
Publisher: Public Library of Science (PLoS)
Abstract: 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.
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It is part of: PLoS One, 2015, vol. 10, num. 4, p. e0123392
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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