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Worse patient VAS occurs at weeks 7 and 8 after infliximab infusions
  1. N Shenker1,
  2. R Haigh2,
  3. A Clarke1
  1. 1Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, BA1 1RL, UK
  2. 2Department of Rheumatology, Royal Devon and Exeter Hospital, Exeter, UK
  1. Correspondence to:
    Dr N Shenker

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The new tumour necrosis factor α (TNFα) blockers are revolutionising the treatment of patients with resistant rheumatoid arthritis. Generally good response rates are seen and the treatments are well tolerated. These agents, however, are costly and questions about their long term side effects remain. In the UK, the administration of infliximab and etanercept has been reviewed by NICE, and guidelines were published in March, 2002.1 They recommend that “non-responders” discontinue treatment after 3 months. Non-responders are defined by a Disease Activity Score using a 28 joint count (DAS28) that remains greater than 3.2 or has not reduced by at least 1.2 from the score before treatment.

Anecdotal evidence suggests that patients become increasingly symptomatic towards the end of the 8 weeks between infusions. …

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