Treatment interruption of biological drugs and tofacitinib in rheumatoid arthritis: A systematic review of case reports

  • Astrid Wiens Universidade Federal do Paraná, Departamento de Farmácia
  • Helena Hiemisch Lobo Borba Universidade Federal do Paraná, Departamento de Farmácia
  • Letícia Paula Leonart Universidade Federal do Paraná, Departamento de Farmácia
  • Fernanda Stumpf Tonin Universidade Federal do Paraná, Departamento de Farmácia
  • Laiza Maria Steimbach Universidade Federal do Paraná, Departamento de Farmácia
  • Ariane Gonçalves Silva de Araújo Universidade Federal do Paraná, Departamento de Farmácia
  • Thais Piazza Universidade Federal Fluminense, Departamento de Farmácia e Administração Farmacêutica
  • Vinicius Lins Ferreira Universidade Federal do Paraná, Departamento de Farmácia
  • Roberto Pontarolo Universidade Federal do Paraná, Departamento de Farmácia
Keywords: Rheumatoid arthritis, Biological drugs/treatment interruption, Tofacitinib, Adverse events

Abstract

The aim of this study was to evaluate interruption of treatment with biological drugs and tofacitinib due to adverse events in patients with rheumatoid arthritis. A systematic review was performed in the electronic databases MEDLINE, Cochrane, Scopus, CRD, IPA, Lilacs and Scielo. Case reports addressing interruption of treatment due to any adverse event related to abatacept (ABA), adalimumab (ADA), anakinra (ANA), certolizumab pegol (CER), etanercept (ETA), golimumab (GOL), infliximab (IFX), rituximab (RTX), secukinumab (SEC), tocilizumab (TCZ), tofacitinib (TOF) or ustekinumab (UST) in rheumatoid arthritis patients were evaluated. Baseline data, patient profile, previous and current treatments, cause of discontinuation and information on reintroduction of treatment were extracted from the case reports. One hundred and fifty-four studies (154 patients) reported 162 discontinuations of rheumatoid arthritis treatment due to adverse events (ETA = 57; IFX = 46; ADA = 32; TCZ = 13; RTX = 5; ANA = 3; GOL = 2; ABA = 2; TOF = 1; CER = 1; SEC = 0 and UST = 0). The mean age of patients was 56 (± 12.1) years and 82% were female. Seventy-four adverse events were confirmed (related to used drug), and 138 were observed in patients using anti-TNF. The most common adverse events were infections (21%), skin disease (15%), autoimmune disease (13%) and hematological disorders (9%). Case reports are important in the detection of rare adverse events and should be considered in the choice of appropriate therapy for patients.

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Published
2018-12-20
How to Cite
Wiens, A., Borba, H., Leonart, L., Tonin, F., Steimbach, L. M., Araújo, A., Piazza, T., Ferreira, V., & Pontarolo, R. (2018). Treatment interruption of biological drugs and tofacitinib in rheumatoid arthritis: A systematic review of case reports. Brazilian Journal of Pharmaceutical Sciences, 54(4), e17437. https://doi.org/10.1590/s2175-97902018000417437
Section
Articles