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of PsA patients that use adalimumab are therefore not able to profit from its optimal clinical benefit," Vogelzang concluded.
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Paris, France, 11 June 2014: Data Louis Vuitton Graffiti Bag presented today at the European League Against Rheumatism Annual Congress (EULAR 2014) showed that a significant number of patients with psoriatic arthritis (PsA) were not receiving doses of the tumour necrosis factor alpha (TNFa) inhibitor adalimumab necessary to achieve optimal clinical benefit.1 Further data revealed that, in the case of the TNFa inhibitor infliximab, nearly three quarters of Louis Vuitton Case
International guidelines recommend that patients with arthritis PsA prescribed the TNFa inhibitor infliximab should be dosed with 5 mg/kg bodyweight every 8th week. However, responses to lower doses have not been previously well documented.2
PsA patients were on doses lower than recommended in international guidelines. 2
This was a prospective cohort study in which 103 consecutive patients diagnosed with PsA were treated with 40 mg adalimumab subcutaneously every other week. Adalimumab concentrations at 28 weeks of treatment were measured in serum trough samples, using an enzyme linked immunosorbent assay (ELISA). Clinical response was defined as a change in disease activity score in 28 joints (?DAS28) between baseline and week 28. At 28 weeks of treatment, serum trough concentrations ranged from 0.0 to 18.8 mg/L, with a mean of 7.2 mg/L. In 48 (47%), trough adalimumab concentrations exceeded the optimal threshold of 8 mg/L.
"These results linking serum adalimumab trough concentrations to clinical response in PsA patients confirmed the findings from a previous study in RA patients," 6 said Mr. Erik Vogelzang.
"However, interestingly, of the 103 consecutive patients with PsA prescribed adalimumab, 36 (35%) appeared to be receiving less than optimal dosing, with a trough adalimumab concentration below 5 mg/L (the lowest point of this ideal dose range). A substantial group Louis Vuitton Bags Celebrities Carrying
"More than 70% of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the recommended 5 mg/kg every eight weeks," said Louis Vuitton Vintage
Danish patients received higher infliximab doses than Icelandic patients at baseline (median (IQR) 3.1 (3.0 3.8) mg/kg vs. 2.3 (2.1 2.9) mg/kg, p.
Low dosing of infliximab does not appear to alter treatment response or adherence
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? In the first study, after 28 weeks of treatment one third of PsA patients were found to have serum adalimumab trough concentrations below the 5 mg/L level shown to have an optimal effect. Erik Vogelzang of the Jan van Breemen Research Institute, Reade, Amsterdam, Netherlands reported that serum trough levels of adalimumab of 5 8 mg/L appeared necessary to achieve the most optimal clinical benefit. Concentrations above 8 mg/L appeared to confer no additional benefit; however, concentrations of approximately 1.0 mg/L showed reasonable efficacy.1
Dr Bente Glintborg of the Copenhagen Centre for Arthritis Research, and Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Denmark presented the clinical outcomes in a large cohort of TNFa inhibitor nave PsA patients treated with infliximab, stratified by country (Denmark vs. Iceland), and by their dose regimen and escalation.
Dr Glintborg. "Lower start doses did not appear to affect either drug adherence or response," she added. Thus, in clinical practise a low start infliximab dose with subsequent step up therapy seems to be an efficient strategy.
EULAR One Third Of Psoriatic Arthritis Patients Are Not Receiving Optimal Dosing Of Adalim
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