Evaluation of Therapeutic Response Under Biologic Therapy in Patients with Rheumatoid Arthritis

Abstract

Biotherapy has revolutionized the therapeutic management of rheumatoid arthritis (RA). The objective of the study was to evaluate and compare the efficacy and tolerance of biological disease modifying antirheumatic drugs (bDMARDs) and conventional disease modifying antirheumatic drugs ( cDMARDs) used in RA.
 It was a retrospective study covering 13 years at the level of the immunology unit of the UHU Hassiba Ben Bouali Blida and functional rehabilitation service of the CHU Frantz Fanon Blida. We identified 1866 records of patients with RA, 75 receiving biotherapy and 71 receiving conventional treatment. The therapeutic response was evaluated by the DAS 28-ESR (disease activity score based on erythrocyte sedimentation rate) and interpreted according to the EULAR (European league against rheumatism) judgements criteria.
 A female predominance of 83%, the average age of RA patients was 49.3 ±13.42 years, the mean starting DAS28-ESR was 5.625± 1.4. 84% of patients initially received MTX (methotrexate) on the front line, the decrease in DAS28-ESR was non- significant, with patients exhibiting intolerance (41%), and (45%) ineffectiveness. The introduction of biotherapy mainly Actemra allowed a decrease of DAS28-ESR of - 1.842±0.3812, a significant decrease according to the criteria of the EULAR. Humira had an adverse efficacy and tolerance profile (including the occurrence of severe adverse effects (AEs)).
 In conclusion, biotherapy is more effective than conventional treatments, while in terms of tolerance data are insufficient to make a judgment on it.
 Keywords: Rheumatoid arthritis – Biotherapy.