P Härle1. 1. Klinik für Rheumatologie, Klinische Immunologie und Physikalische Therapie, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland, p-haerle@kkmainz.de.
Abstract
INTRODUCTION: Data with respect to safety and therapeutic efficacy for the combination of biological DMARDs is scarce and inhomogeneous in order to make final conclusions. To this end, data to biologic combinations is disappointing due to relatively low therapeutic efficacy and partially enhanced rates of severe infectious events. METHODS: Combining biologics is an option only in very special situations (RTX plus TNFi). In addition, the relation of financial effort to therapeutic efficacy is questionable, especially in the situation of numerous drug options (anti-cytokine principle, T-cell inhibition, B-cell depletion) and therapeutic strategies of combining biologics with DMARDs. Generally speaking, combinations of biological should only be used in clinical trials. New drugs influencing intracellular signaling pathways (small molecules) are going to be approved or are already approved by the drug agencies, thus, adding to the existing armamentarium. Furthermore, combinations with these new molecules are going to be interesting. CONCLUSIONS: This review summarizes the available studies concerning combination of biologicals in a tabular fashion.
INTRODUCTION: Data with respect to safety and therapeutic efficacy for the combination of biological DMARDs is scarce and inhomogeneous in order to make final conclusions. To this end, data to biologic combinations is disappointing due to relatively low therapeutic efficacy and partially enhanced rates of severe infectious events. METHODS: Combining biologics is an option only in very special situations (RTX plus TNFi). In addition, the relation of financial effort to therapeutic efficacy is questionable, especially in the situation of numerous drug options (anti-cytokine principle, T-cell inhibition, B-cell depletion) and therapeutic strategies of combining biologics with DMARDs. Generally speaking, combinations of biological should only be used in clinical trials. New drugs influencing intracellular signaling pathways (small molecules) are going to be approved or are already approved by the drug agencies, thus, adding to the existing armamentarium. Furthermore, combinations with these new molecules are going to be interesting. CONCLUSIONS: This review summarizes the available studies concerning combination of biologicals in a tabular fashion.
Authors: Stanley B Cohen; Paul Emery; Maria W Greenwald; Maxime Dougados; Richard A Furie; Mark C Genovese; Edward C Keystone; James E Loveless; Gerd-Rüdiger Burmester; Matthew W Cravets; Eva W Hessey; Timothy Shaw; Mark C Totoritis Journal: Arthritis Rheum Date: 2006-09
Authors: Kenneth G Saag; Gim Gee Teng; Nivedita M Patkar; Jeremy Anuntiyo; Catherine Finney; Jeffrey R Curtis; Harold E Paulus; Amy Mudano; Maria Pisu; Mary Elkins-Melton; Ryan Outman; Jeroan J Allison; Maria Suarez Almazor; S Louis Bridges; W Winn Chatham; Marc Hochberg; Catherine MacLean; Ted Mikuls; Larry W Moreland; James O'Dell; Anthony M Turkiewicz; Daniel E Furst Journal: Arthritis Rheum Date: 2008-06-15
Authors: Michael Weinblatt; Michael Schiff; Allan Goldman; Joel Kremer; Michael Luggen; Tracy Li; Dalei Chen; Jean-Claude Becker Journal: Ann Rheum Dis Date: 2006-08-25 Impact factor: 19.103
Authors: Maria W Greenwald; William J Shergy; Jeffrey L Kaine; Marianne T Sweetser; Kye Gilder; Matthew D Linnik Journal: Arthritis Rheum Date: 2011-03
Authors: Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maxime Dougados; Paul Emery; Cecile Gaujoux-Viala; Simone Gorter; Rachel Knevel; Jackie Nam; Monika Schoels; Daniel Aletaha; Maya Buch; Laure Gossec; Tom Huizinga; Johannes W J W Bijlsma; Gerd Burmester; Bernard Combe; Maurizio Cutolo; Cem Gabay; Juan Gomez-Reino; Marios Kouloumas; Tore K Kvien; Emilio Martin-Mola; Iain McInnes; Karel Pavelka; Piet van Riel; Marieke Scholte; David L Scott; Tuulikki Sokka; Guido Valesini; Ronald van Vollenhoven; Kevin L Winthrop; John Wong; Angela Zink; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2010-05-05 Impact factor: 19.103
Authors: Mark C Genovese; Stanley Cohen; Larry Moreland; Deborah Lium; Sean Robbins; Richard Newmark; Pirow Bekker Journal: Arthritis Rheum Date: 2004-05
Authors: M C Genovese; F C Breedveld; P Emery; S Cohen; E Keystone; E L Matteson; Y Baptiste; A Chai; L Burke; W Reiss; M Sweetser; T M Shaw Journal: Ann Rheum Dis Date: 2009-01-20 Impact factor: 19.103