Abstract

DIAZ-COTO, José Francisco  and  SILESKY, Francisco Brenes. Efficacy of anti-TNF agents in a cohort of patients with rheumatoid arthritis in Costa Rica. Rev.Colomb.Reumatol. [online]. 2010, vol.17, n.4, pp.205-211. ISSN 0121-8123.

Objectives: To determine the efficacy of the anti-TNF-α therapy among patients with rheumatoid arthritis (RA) and to identify predictors of treatment response to these therapy. Methods: RA patients, older than 18, were included. These patients belong to the Costa Rican Social Security System. They are under medical control and have received an anti-TNF-α agent. Efficacy of the biological therapy was determined based in: 1. The continuity of the established treatment, 2. The achieved control, according to the physician's subjective criteria, 3. EULAR good response and 4. EULAR remission. Results: In total, 66 patients were included in the study. 45.5% of the patients achieved EULAR remission. The relative risk (RR) of not achieving remission in patients of more than 50 years old was 2.22% (IC 95% = 1.03-4.77%), in patients with DAS 28 score at baseline > 6 was 2.66 (IC 95% = 1.14-6.20) and in patients with more than 10 years of AR diagnosis, the RR was 4.0 (IC 95%= 1.30-12.22). Conclusions: The use of anti-TNF in patients that disease previously resistant to conventional DMAR achieved a 45% EULAR remission. The age in which the therapy starts; long-standing disease and the higher DAS 28, are negative predictors of treatment response to anti-TNF therapy.

Keywords : rheumatoid arthritis; tumor necrosis factor α; treatment efficacy.

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