The use of TNF Blockers in the Rheumatology Outpatient Clinic, Doha, Qatar

Abstract

Background: The currently available TNF blocking agents include ifliximab, etanercept and adalimumab. They are approved for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis in the United States and Europe. Also TNF blockers are used currently in other rheumatic and non-rheumatic disease. Objective: Primary objective: To evaluate our practice of using TNF blockers in the outpatient rheumatology clinics at Hamad Medical Corporation in Qatar, to evaluate the response rate to TNF blockers, and the rate of switching from one TNF blockers to another. Secondary objective: to assess rate of serious infection and TB. Methods: The study involved a retrospective chart review of 82 patients in rheumatology outpatient clinic since the introduction of TNF-Blockers at Hamad Medical Corporation in 2002 till December of2005. Results: Twenty two patients out of 82 received Infliximab (26.8%), 51 patients received etanercept (62.1%) and 22 patients received adalimumab (26.8%) including switchers and non switchers. Response rate was 82% to initial TNF blocker in RA, and almost 100% in Psoriatic arthritis and ankylosing spondylitis. Reason of switching was either due to no response or side effects. No significant serious adverse events in our cohort and no TB reactivation. Conclusion: Our data are comparable with the international guidelines; regarding the use of TNF blockers in rheumatic disease.also they reflect the daily practice in the rheumatology outpatient clinic in Qatar.