Anti-TNF drugs not as effective as thought | Arthritis Information
This article describes how TNF antagonist drugs have performed better in clinical trials than in practical application, and the reasons why:
Better Management More Important in RA Than New Drugs:
http://www.medpagetoday.com/Rheumatology/Arthritis/11933
"The most feasible explanation, they said, is that the cohort in their study included mainly long-standing patients and TNF antagonists was probably prescribed for those with more severe disease at the beginning of the study.
Patients in clinical practice are generally older and have more comorbidities that those in clinical trials. Furthermore, changes in tender-joint counts may be harder to detect in older patients as well as those with longer disease duration.
Considering all this, the researchers said, "we need specific markers of RA severity that allow us to select adequate patients for early biologic treatment in order to improve their therapeutic response as well as functional outcome.
These tools, they concluded "may also help to improve the cost-effectiveness of these drugs, avoiding unnecessary prescriptions."
Sounds as if there's a difference in how RA markers are established between clinical trials and active practice RDs. It will be interesting to see what the outcomes would be if all things were created equal.
I can only assume that I'm the anomoly - an older patient with severe, long standing disease who has responded well to TNF therapy with an increase in MXT and an additional DMARD added. There are many who have responded well and many who haven't. The same as all of the other treatments for RA. Lindy
[QUOTE=LinB]
"The most feasible explanation, they said, is that the cohort in their study included mainly long-standing patients and TNF antagonists was probably prescribed for those with more severe disease at the beginning of the study.
Patients in clinical practice are generally older and have more comorbidities that those in clinical trials. Furthermore, changes in tender-joint counts may be harder to detect in older patients as well as those with longer disease duration.
Considering all this, the researchers said, "we need specific markers of RA severity that allow us to select adequate patients for early biologic treatment in order to improve their therapeutic response as well as functional outcome.
These tools, they concluded "may also help to improve the cost-effectiveness of these drugs, avoiding unnecessary prescriptions."
Sounds as if there's a difference in how RA markers are established between clinical trials and active practice RDs. It will be interesting to see what the outcomes would be if all things were created equal.
I can only assume that I'm the anomoly - an older patient with severe, long standing disease who has responded well to TNF therapy with an increase in MXT and an additional DMARD added. There are many who have responded well and many who haven't. The same as all of the other treatments for RA. Lindy
[/QUOTE]
How very true. Just like not everyone responds well to AP..................
Lynn492008-11-26 18:05:26Well, I guess this article is open to various interpretations.
Lynne, I was merely posting a news article that appeared this morning---that's something you do very often (and mine is actually current). Why would you snipe at AP in response to it? Frankly, that seems like hostile and bullying behaviour to me. No RA treatment works for everyone, yet you deride AP for this fact whenever you see an opportunity. Are you trying to bully APers into silence? You should chill out.I was on Enbrel with MTX (for 5 years), just switched to Humira with MTX. It has only been 2 months, granted, but things are not changing for the good for me. I feel like I need to try something radical. I feel like my time is running out as I am about to go thru yet another round of surgery once I am over the pneumonia I now have. Sucky and scary and confusing.
waddie, that is my least favourite story. I hope you find something that works for you soon.
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