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Adalimumab treatment in patients of rheumatoid arthritis with renal insufficiency
Arthritis Care & Research , 07/18/2012
Clinical Article
Sumida K et al. – The data indicate that adalimumab (ADA) does not worsen renal function and has no serious adverse events even for rheumatoid arthritis (RA) patients with renal insufficiency, including those undergoing hemodialysis (HD), and suggest that it could be a potential therapeutic option for them.
Methods- Sixty–five RA patients including two patients undergoing HD treated with ADA in the hospital from 1 December 2008 to 30 June 2011 were retrospectively analyzed.
- The renal function was evaluated by estimated glomerular filtration rate calculated from the Cockroft–Gault formula (CG–eGFR) at the start and end of follow–up after ADA treatment.
- The proportion of the patients who discontinued or switched ADA treatment and the change of CG–eGFR were compared between patients with (n = 39) and without (n = 26) renal insufficiency, defined as CG–eGFR less than 60 mL/min/1.73m2.
- There was no significant difference between the two groups in the proportion of the patients who discontinued or switched ADA treatment (51.3% vs. 50.0%, P = 0.53).
- The changes of CG–eGFR were from 41.6 ± 13.3 to 43.4 ± 17.9 ml/min/1.73m2 in patients with renal insufficiency and from 83.6 ± 17.5 to 83.0 ± 16.8 ml/min/1.73m2 in patients without renal insufficiency, and the differences in each group were not statistically significant (P = 0.92 and P = 0.78, respectively).
- No severe infections or other severe adverse events were observed in either group during ADA treatment.