Bevacizumab en el tratamiento de la degeneración macular neovascular asociada a la edad / Treatment of neovascular age-related macular degeneration with bevacizumab

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[Effectiveness and safety of adalimumab and etanercept for rheumatoid arthritis in a third-level hospital]. / Efectividad y seguridad de adalimumab y etanercept en artritis reumatoide en un hospital de tercer nivel.

OBJECTIVE: To assess the effectiveness of adalimumab and etanercept at 6 and 12 months after therapy onset using DAS28, EULAR (European League Against Rheumatism), and ACR (American College of Rheumatology) criteria, and to analyze safety. METHOD: A prospective, 12-month, observational study of a patient cohort diagnosed with rheumatoid arthritis who were started on adalimumab or etanercept at the Rheumatology Department between January 2003 and December 2004. DAS28, EULAR, and ACR criteria were examined at 6 and 12 months. An intention-to-treat analysis was performed, and adverse reactions were quantitized. RESULTS: Ninety-nine patients were included - 50 on adalimumab and 49 on etanercept. Of these, 30 and 20%, respectively, received monotherapy. No differences in effectiveness were seen between both drugs during the studied periods of time according to DAS28. EULAR response to adalimumab at 6 and 12 months was: good 28 and 38%; moderate 40 and 36%; nil 10 and 4%; regarding etanercept at 6 and 12 months: good 29 and 43%; moderate 31 and 24%; nil 18 and 10%. As regards adalimumab at 6 and 12 months: ACR20: 64 and 62%; ACR50: 44 and 46%; ACR70: 22 and 26%; as regards etanercept at 6 and 12 months: ACR20: 61 and 65%; ACR50: 41 and 45%; ACR70: 16 and 24%. Eleven patients discontinued therapy in each group. CONCLUSIONS: Adalimumab and etanercept had a similar effectiveness in our population. Criteria of use may condition results, and thus awareness of other hospitals experience is encouraged.

Efectividad y seguridad de adalimumab y etanercept en artritis reumatoide en un hospital de tercer nivel / Effectiveness and safety of adalimumab and etanercept for rheumatoid arthritis in a third-level hospital

Objetivo: Valorar la efectividad de adalimumab y etanercept alos 6 y 12 meses de tratamiento mediante DAS28, criteriosEULAR (European League Against Rheumatism) y ACR (AmericanCollege of Rheumatology) y analizar la seguridad.Método: Estudio observacional, prospectivo, durante 12meses, de una cohorte de pacientes diagnosticados de artritis reumatoide,que iniciaron tratamiento con adalimumab o etanercepten el servicio de reumatología entre enero de 2003 y diciembrede 2004. Se determinaron criterios DAS28, EULAR y ACR a los6 y 12 meses. Se analizó por intención de tratar y se cuantificaronlas reacciones adversas.Resultados: Se incluyeron 99 pacientes, 50 con adalimumaby 49 con etanercept, de ellos el 30 y 20% en monoterapia. Nohubo diferencia de efectividad según DAS28 entre ambos fármacosen los periodos estudiados. La respuesta EULAR para adalimumaba los 6 y 12 meses fue: buena 28 y 38%, moderada 40 y36%, y ninguna 10 y 4% y para etanercept: buena 29 y 43%,moderada 31 y 24% y ninguna 18 y 10%. Para adalimumab a los6 y 12 meses: ACR20: 64 y 62%; ACR50: 44 y 46%; ACR70:22 y 26% y para etanercept a los 6 y 12 meses: ACR20: 61 y65%; ACR50: 41 y 45%; ACR70: 16 y 24%. Cesaron tratamientoen cada grupo 11 pacientes.Conclusiones: Adalimumab y etanercept presentan similarefectividad en nuestra población. Los criterios de utilización puedencondicionar los resultados, por ello es interesante conocer laexperiencia de otros hospitales

Objective: To assess the effectiveness of adalimumab and etanerceptat 6 and 12 months after therapy onset using DAS28,EULAR (European League Against Rheumatism), and ACR (AmericanCollege of Rheumatology) criteria, and to analyze safety.Method: A prospective, 12-month, observational study of apatient cohort diagnosed with rheumatoid arthritis who were startedon adalimumab or etanercept at the Rheumatology Departmentbetween January 2003 and December 2004. DAS28,EULAR, and ACR criteria were examined at 6 and 12 months.An intention-to-treat analysis was performed, and adverse reactionswere quantitized.Results: Ninety-nine patients were included – 50 on adalimumaband 49 on etanercept. Of these, 30 and 20%, respectively,received monotherapy. No differences in effectiveness were seenbetween both drugs during the studied periods of time according toDAS28. EULAR response to adalimumab at 6 and 12 months was:good 28 and 38%; moderate 40 and 36%; nil 10 and 4%; regardingetanercept at 6 and 12 months: good 29 and 43%; moderate31 and 24%; nil 18 and 10%. As regards adalimumab at 6 and 12months: ACR20: 64 and 62%; ACR50: 44 and 46%; ACR70: 22and 26%; as regards etanercept at 6 and 12 months: ACR20: 61and 65%; ACR50: 41 and 45%; ACR70: 16 and 24%. Elevenpatients discontinued therapy in each group.Conclusions: Adalimumab and etanercept had a similar effectivenessin our population. Criteria of use may condition results, andthus awareness of other hospitals experience is encouraged