Rheumatoid Arthritis: van den Bemt BJ

van den Bemt BJ, van Lankveld WG. · No affiliation provided · Nat Clin Pract Rheumatol. · Pubmed #18037928 No free full text.

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van den Bemt BJ, van den Hoogen FH, Breedveld FC, van der Tempel H, Janknegt R. · Sint Maartenskliniek, Herngstdalseweg 3, 6522JV Nijmegen, The Netherlands. · Expert Opin Pharmacother. · Pubmed #16925504 No free full text.

Abstract: This article offers an interactive decision matrix technique (InforMatrix), in which a group of experts in rheumatology determine an order of merit within the various biologicals used for rheumatoid arthritis. In this order of merit, six criteria (efficacy, safety, tolerance, ease of use, applicability and costs) are weighed against each other. Data necessary for this weighing process are derived from both literature, as well as clinical practice experience. This article provides an overview of the most relevant clinical trials on the biologicals, as well as a description of the interactive decision matrix technique. Using this interactive matrix technique makes rational consideration of the treatment options for rheumatoid arthritis possible.

van den Bemt BJ, den Broeder AA, Snijders GF, Hekster YA, van Riel PL, Benraad B, Wolbink GJ, van den Hoogen FH. · Department of Pharmacy, Sint Maartenskliniek, PO Box 9011, 6500 GM, Nijmegen, The Netherlands. · Ann Rheum Dis. · Pubmed #18245109 No free full text.

Abstract: OBJECTIVES: In clinical trials only a small subset of patients with rheumatoid arthritis (RA) benefits from higher than standard dose of infliximab (>3 mg/kg/8 weeks). However, dose escalation of infliximab is frequently applied in clinical practice. Individual adjustment of infliximab treatment based on actual disease activity, instead of subjective clinical judgement, could prevent possible unwarranted dose escalation. METHODS: The infliximab dose of all patients with RA treated at our centre was decreased from 5 mg/kg to 3 mg/kg, leaving dosing intervals unaltered. Subsequently patients were followed for at least three infusions. At every visit, 28-joint Disease Activity Score (DAS28), infliximab serum trough levels and anti-infliximab antibody levels were assessed. Inversed European League Against Rheumatism (EULAR) criteria (flare criteria) were used as the endpoint. RESULTS: A total of 18 patients were included in the study. Mean (SD) DAS28 scores before dose reduction and after first and second low dose were 3.2 (1.2), 3.2 (1.8) and 3.3 (1.2), respectively (values not significant). One patient (6%, 95% CI 0% to 17%) developed a persistent flare that subsided after increasing infliximab doses and one patient stopped infliximab because of a lupus-like reaction. In all other patients (n=16) lowering infliximab resulted in unaltered disease activity. Infliximab levels showed that most patients had either low- (<1 mg/litre) or high (>5 mg/litre) serum trough levels. Anti-infliximab antibodies were detected in four patients. CONCLUSION: Infliximab dosages of 5 mg/kg can be lowered in the majority of patients with RA using DAS28-guided dose titration without increase of disease activity. Lowering the dose of infliximab should be considered in every patient receiving higher doses infliximab.

van den Bemt BJ, Vos K, den Broeder AA, Blom M, Thurlings RM, Bartelds GM, Stapel SO, Barrera P, Tak PP, Nurmohamed MT, Wolbink GJ. · No affiliation provided · Ann Rheum Dis. · Pubmed #19605744 No free full text.

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Gelinck LB, Teng YK, Rimmelzwaan GF, van den Bemt BJ, Kroon FP, van Laar JM. · No affiliation provided · Ann Rheum Dis. · Pubmed #17881666 No free full text.

This publication has no abstract.