Tea Lamberg, Taina Sipponen, Sanna Valtanen, Kari K Eklund, Tarja Mälkönen, Kristiina Aalto, Katriina Mikola, Kaija-Leena Kolho, Sanna Leinonen, Pia Isomäki, Heidi Mäkinen, Krista-Liisa Vidqvist, Arto Kokko, Laura Huilaja, Minna Kyllönen, Paula Keskitalo, Sirja Sard, Paula Vähäsalo, Ritva Koskela, Liisa Kröger, Perttu Lahtinen, Anna-Maija Haapala, Katja Korkatti, Tuulikki Sokka-Isler & T. Sakari Jokiranta (2022) Short interruptions of TNF-inhibitor treatment can be associated with treatment failure in patients with immune-mediated diseases, Autoimmunity, 55:5, 275-284, DOI: 10.1080/08916934.2022.2067985
Short interruptions of TNF-inhibitor treatment can be associated with treatment failure in patients with immune-mediated diseases
|Author:||Lamberg, Tea1,2; Sipponen, Taina3; Valtanen, Sanna1,2;|
1United Medix Laboratories, Helsinki, Finland
2Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
3Department of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
4Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Orton Orthopedic Hospital Helsinki, Helsinki, Finland
6Department of Dermatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
7New Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
8Pediatric Gastroenterology, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Tays Eye Centre, Tampere University Hospital, Tampere, Finland
10Centre for Rheumatology, Tampere University Hospital, Tampere, Finland
11Department of Rheumatology, Jyväskylä Central Hospital, Jyväskylä, Finland
12PEDEGO Research Unit, University of Oulu, Oulu, Finland
13Department of Dermatology and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
14Department of Rheumatology, Oulu University Hospital, Oulu, Finland
15Department of Pediatrics, Oulu University Hospital, Oulu, Finland
16Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
17Department of Gastroenterology, Oulu University Hospital, Oulu, Finland
18Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
19Department of Gastroenterology, Päijät-Häme Central Hospital, Lahti, Finland
20Department of Clinical Microbiology, Fimlab Laboratories, Tampere, Finland
21Department of Pediatrics, Central Ostrobothnia Central Hospital, Kokkola, Finland
22Medicum, University of Helsinki, Helsinki, Finland
23Tammer BioLab Ltd, Tampere, Finland
|Online Access:||PDF Full Text (PDF, 1.7 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2022081955873
|Publish Date:|| 2022-08-19
Introduction: The prevalence of immune-mediated diseases has increased in the past decades and despite the use of biological treatments all patients do not achieve remission. The aim of this study was to characterise the reasons for short interruptions during treatment with two commonly used TNF-inhibitors infliximab and adalimumab and to analyse the possible effects of the interruptions on immunisation and switching the treatment.
Material and methods: This case-control study was based on retrospective analyses of patient records and a questionnaire survey to clinicians. A total of 370 patients (194 immunised cases and 172 non-immunised controls, 4 excluded) were enrolled from eight hospitals around Finland. Eleven different diagnoses were represented, and the largest patient groups were those with inflammatory bowel or rheumatic diseases.
Results: Treatment interruptions were associated with immunisation in patients using infliximab (p < .001) or adalimumab (p < .000001). Patients with treatment interruptions were more likely to have been treated with more than one biological agent compared to those without treatment interruptions. This was particularly prominent among patients with a rheumatic disease (p < .00001). The most frequent reason for a treatment interruption among the cases was an infection, whereas among the control patients it was remission. The median length of one interruption was one month (interquartile range 1–3 months).
Conclusion: Our results suggest that the interruptions of the treatment with TNF-inhibitors expose patients to immunisation and increase the need for drug switching. These findings stress the importance of careful judgement of the need for a short interruption in the biological treatment in clinical work, especially during non-severe infections.
|Pages:||275 - 284|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
This study was funded by the University of Helsinki, HUS EVO-fund and TEKES (SalWe Get It Done – Personalised Diagnostics and Care Research Program).
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4. 0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.