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ALETH PERDRIGER, XAVIER MARIETTE, JEAN-LOUIS KUNTZ, OLIVIER BROCQ, RYM KARA-TERKI, XAVIER LE LOET, ALAIN CANTAGREL, STEPHAN PAVY, CHANTAL JOB DESLANDRE, FRANÇOISE DEBIAIS, BERNARD COMBE, and the Club Rhumatismes et Inflammation ABSTRACT. Objective. To investigate the safety of infliximab (INF) combination therapy with leflunomide (LEF) or azathioprine (AZA) in patients with rheumatoid arthritis (RA). Method. A standardized questionnaire on the use of INF in combination with LEF or AZA was mailed to hospital physicians and collected over a 2 month period. Adverse events (AE) and the reasons for withdrawal of combination therapy were analyzed. Results. Data on 225 patients with RA were collected retrospectively. INF was used in combination with LEF in 171 patients and with AZA in 54. The duration of INF exposure was similar in both groups (mean 8.8 mo). AE were reported in 75 patients (33.3%), 60 LEF/INF (35%) and 15 AZA/INF combinations (27.8%) (p = nonsignificant). No unexpected AE were observed. The main AE were infections (6.2%), cytopenia (5.8%), hepatotoxicity (5.8%), reactions to infusion (5.3%), and skin reactions (4%). At the time the questionnaires were sent out, 161 patients were continuing combination therapies. The main reasons for drug withdrawal were AE (53 patients, 23.5%), inefficacy (10 patients, 4%), and one temporary discontinuation for surgery. Conclusion. Our study suggests that INF used in combination with LEF or AZA could be an alternative to methotrexate/INF combinations. (J Rheumatol 2006;33:865–9) Key Indexing Terms: INFLIXIMAB
From the Department of Rheumatology, Medical University, Rennes; Department of Rheumatology, Paris-sud University, AP-HP, le Kremlin Bicètre; Department of Rheumatology, Medical University, Strasbourg; Department of Rheumatology, Medical University, Nice; Department of Rheumatology, Medical University, Grenoble; Department of Rheumatology, Medical University, Rouen; Department of Rheumatology, Medical University, Toulouse; Department of Rheumatology A, Cochin University, Paris; Department of Rheumatology, Medical University, Poitiers; and Department of Rheumatology, Medical University, Montpellier, France. A. Perdriger, MD, PhD, Department of Rheumatology, Medical University, Rennes; X. Mariette, MD, PhD, Department of Rheumatology, Paris-sud University; J-L. Kuntz, MD, Department of Rheumatology, Medical University, Strasbourg; O. Brocq, MD, Department of Rheumatology, Medical University, Nice; R. Kara-Terki, MD, Department of Rheumatology, Medical University, Grenoble; X. Le Loet, MD, Department of Rheumatology, Medical University, Rouen; A. Cantagrel, MD, PhD, Department of Rheumatology, Medical University, Toulouse; S. Pavy, MD, Department of Rheumatology A, Cochin University; C. Job Deslandre, MD, Department of Rheumatology A, Cochin University; F. Debiais, MD, PhD, Department of Rheumatology, Medical University, Poitiers; B. Combe, MD, PhD, Department of Rheumatology, Medical University, Montpellier. Address reprint requests to Prof. A. Perdriger, Service de Rhumatologie, Hôpital Sud, CHU de Rennes, 16 Boulevard de Bulgarie, 35056 Rennes Cedex, France. E-mail: aleth.perdriger@chu-rennes.fr Accepted for publication December 29, 2005.
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