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Factors Influencing Adalimumab Treatment Response in Patients with Rheumatoid Arthritis: The Future of Clinical Expertise

Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition, ongoing advancements in therapeutic development have resulted in the production of medications that exhibit enhanced efficacy and safety characteristics. However, further investigation is required before RA can be deemed a manageable pathology. This review presents an analysis of the utilization of adalimumab for the treatment of RA by synthesizing information from relevant literature and emphasizing its effectiveness and safety to improve overall outcomes along with potential cost reductions for patients with RA.

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Publication Date
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
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Publication Date
Sun Apr 05 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Predictors of Response to (Etanercept) in the Treatment of Iraqi Patients with Active Rheumatoid Arthritis

Background: Since the introduction of tumour necrosis factor-alpha (TNF-α) inhibitors including etanercept, their efficacy and safety in treatment of rheumatoid arthritis (RA) have been studied in many randomized controlled clinical trials. However, data regarding predictors of clinical response to anti-TNF therapy are still sparse.
Objective: To assess the predictors of response to etanercept in treatment of Iraqi patients with active RA.
Methods: An open label single group prospective study was conducted over 15 months on 190 Iraqi patients with RA. All the included patients were given etanercept at a dose of 50 mg by subcutaneous injection on
a weeklybases. Each patient was followed at regular intervals of bas

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Cytokine Profile in Patients with Rheumatoid Arthritis

Background: Cytokines produced by inflammatory cells play a pivotal role in synovial inflammation and joint destruction in rheumatoid arthritis.
Patients and Methods: The cytokine serum levels were measured by EASIA (Enzyme amplified sensitivity immunoassay) in sera from 50 RA patients, and 40 healthy donors. Cytokine levels were compared in different RA subpopulations (positive or negative rheumatoid factor (RF), long term or recent onset disease, high or low disease activity). In addition, the possible association with other demographic and clinical parameters (gender, age, etc) was also analyzed.
Results: It was demonstrated that IL-2, IL-6 and IFN-δ levels were elevated in serum samples of RA pati

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Publication Date
Wed Apr 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Proinflammatory cytokines profile in patients with Rheumatoid arthritis

Background:
Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. RA is a systemic disease, often affecting extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. 
Patients and Methods: Enzyme immunoassay for Determination of human TNF- , IL-1 and GM-CSF in serumsamples from50 patients with a diagnosis of rheumatoid arthritis
Results: of cytokines showed a significant increase in TNF-alpha, IL-1 beta and GM-CSF in patients with rheumatoid arthrit

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Estimation levels of CTHRC1and some cytokines in Iraqi patients with Rheumatoid Arthritis

Collagen triple helix repeat containing-1 (CTHRC1) is an essential marker for Rheumatoid Arthritis (RA), but its relationship with pro-inflammatory, anti-inflammatory, and inflammatory markers has been scantily covered in extant literature. To evaluate the level of CTHRC1 protein in the sera of 100 RA patients and 25 control and compare levels of tumour necrosis factor alpha (TNF-α), interleukin 10 (IL-10), RA disease activity (DAS28), and inflammatory factors. Higher significant serum levels of CTHRC1 (29.367 ng/ml), TNF-α (63.488 pg/ml), and IL-10 (67.1 pg/ml) were found in patient sera as compared to that in control sera (CTHRC1 = 15.732 ng/ml, TNF-α = 33.788 pg/ml, and IL-10 = 25.122 pg/ml). There was no significant correlation be

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Publication Date
Wed Jan 02 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Pulmonary involvement for patients with Rheumatoid Arthritis: Spirometric study

Background: Pulmonary involvement in patients with Rheumatoid Arthritis (RA) is a serious extra articular manifestation.

Patients and Methods: 82 patients with RA and 40 control subjects were included in this prospective study. They were submitted to medical history, physical measurements (height, weight and BMI) and spirometric evaluation for FVC, FEV1, FEV1%, PEFR and FMF (FEF25-75%).Objective: The aim of the study is to detect pulmonary involvement, classify the type of involvement (whether obstructive, restrictive or mixed), and to find out whether pulmonary system was involved in the early stage of the disease and is asymptomatic and to determine the as

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Science
MTHFR Gene Polymorphisms in Iraqi Kurdish Rheumatoid Arthritis Patients: Relation to Methotrexate Response and Toxicity

     Methotrexate (MTX) is still one of the gold standard treatments for rheumatoid arthritis (RA). It shows diverse outcomes in blood level and clinical response, this was demonstrated by its relation to the genetic polymorphism in the pharmacogenetic study. This study aimed to investigate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in relation to MTX efficacy and toxicity in Iraqi Kurdish RA patients. Sixty-four RA patients were involved in this study with an average age of 47.78 ±14.08 and female to male ratio of (8.1). Diagnosis and disease activity were confirmed. Blood analyses, including those of laboratory markers of disease activity, were done. The 28 joint disease activity score (DAS28-CRP) w

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
Assessment of Serum Prolactin Level in Patients Women with Rheumatoid Arthritis

The prolactin hormone played role in the many autoimmune disorders. To determine the importance of high levels of prolactin in triggering rheumatoid arthritis, thirty patient's women with hyperprolactinemia aged (20-45) years old have been investigated and compared with twenty five healthy individuals. All the studied groups were carried out to measure the concentration of citrulinated peptide(CCP) by enzyme linked immunosorbent assay( ELISA), antikeratin antibodies (AKA)and antinuclear antibodies(ANA) by indirect fluorescent assay IFAT. There was a significant elevation of CCP concentration compared with control groups (P< 0.05). The percentage of antikeratin antibodies and antinuclear antibodies was (20%, 10%) respectively, and

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Development of Anti-bodies against Infliximab in Iraqi Patients with Rheumatoid Arthritis.

Background: Rheumatoid arthritis is a common chronic and destructive autoimmune arthropathy .Treatment with infliximab gives great improvement to a large numbers of patients with RA ,however, in some patients after prolonged treatment infliximab can induce anti-infliximab antibodies formation and result to loss of infliximab efficacy and active persistent disease.
Objective: to investigate the frequency of anti-infliximab antibodies in Iraqi patients with rheumatoid arthritis.
Patients and methods: fifty Iraqi RA patients(36 females and 14 males) compared with 50 control( 25 healthy control and 25 case control (patients with RA on other treatment) ) were included in this study from begging of March 201

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Physiological and Immunological Disturbance in Rheumatoid Arthritis Patients

            Rheumatoid arthritis (RA) is a systematic autoimmune disorder with chronic inflammation changes of unknown etiology. Various synovial inflammatory and proliferative alterations may contribute to the cartilaginous tissues and invasive bony tissues, leading to destructive joints and malformed bones. This disease is mostly due to infective microorganisms or genetic susceptibility causing immune system disturbances through triggering both T-cells and B-cells. Furthermore, different immune cells may secret cytokines, which are responsible for some RA pathogenesis activity. From ninety individuals, serum sample was collected; thirty of them were normal and sixty cases were patients with RA attended a privet medical clin

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