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Do etanercept-naive patients with rheumatoid arthritis respond better to infliximab than patients for whom etanercept has failed?
  1. Y Yazici1,
  2. D Erkan2
  1. 1Brooklyn Heights Arthritis Associates, Long Island College Hospital, New York, USA
  2. 2Hospital for Special Surgery, New York, USA
  1. Correspondence to:
    Dr Y Yazici;

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We read with interest the article by van Vollenhoven et al.1 In short, they report on 31 patients with rheumatoid arthritis (RA), 18 of whom used etanercept (ETA) first and then switched to infliximab (IFX)in most part because of inefficacy, and 13 patients who used IFX first and changed to ETA mostly owing to adverse events. They suggested using the other tumour necrosis factor (TNF) inhibitor when one of them fails. Although, in general, agreeing with their findings, we would like to present our experience which is somewhat different from theirs and to discuss the possible reasons for this.

We set up an IFX registry at the Hospital for Special Surgery in February 2000, with the start of IFX infusions. The registry collected prospective data on all the patients with RA who started treatment with IFX, and followed up them every 2 months until May 2001. All patients completed questionnaires about their RA history, treatment, and functional disability (modified Health Assessment Questionnaire (mHAQ)) at baseline and every 2 months thereafter. A 42 joint count for tender and swollen joints was performed at each visit. Patients were telephoned 3–5 days after infusions and asked about …

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