Efectividad y seguridad de adalimumab y etanercept en artritis reumatoide en un hospital de tercer nivel

Bernal Rivera, L; Guerrero Aznar, M D; Monzón Moreno, A; Beltrán García, M; Hernández Cruz, B; Colmener, M A

doi:10.1016/S1130-6343(06)73979-4

Farmacia Hospitalaria

ISSN: 1130-6343

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Objetivo: Valorar la efectividad de adalimumab y etanercept a los 6 y 12 meses de tratamiento mediante DAS28, criterios EULAR (European League Against Rheumatism) y ACR (American College of Rheumatology) y analizar la seguridad. Método: Estudio observacional, prospectivo, durante 12 meses, de una cohorte de pacientes diagnosticados de artritis reumatoide, que iniciaron tratamiento con adalimumab o etanercept en el servicio de reumatología entre enero de 2003 y diciembre de 2004. Se determinaron criterios DAS28, EULAR y ACR a los 6 y 12 meses. Se analizó por intención de tratar y se cuantificaron las reacciones adversas. Resultados: Se incluyeron 99 pacientes, 50 con adalimumab y 49 con etanercept, de ellos el 30 y 20% en monoterapia. No hubo diferencia de efectividad según DAS28 entre ambos fármacos en los periodos estudiados. La respuesta EULAR para adalimumab a los 6 y 12 meses fue: buena 28 y 38%, moderada 40 y 36%, y ninguna 10 y 4% y para etanercept: buena 29 y 43%, moderada 31 y 24% y ninguna 18 y 10%. Para adalimumab a los 6 y 12 meses: ACR20: 64 y 62%; ACR50: 44 y 46%; ACR70: 22 y 26% y para etanercept a los 6 y 12 meses: ACR20: 61 y 65%; ACR50: 41 y 45%; ACR70: 16 y 24%. Cesaron tratamiento en cada grupo 11 pacientes. Conclusiones: Adalimumab y etanercept presentan similar efectividad en nuestra población. Los criterios de utilización pueden condicionar los resultados, por ello es interesante conocer la experiencia de otros hospitales.

Palabras clave:

Terapias biológicas

Artritis reumatoide

Adalimumab

Etanercept

Eficacia

Seguridad

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