A pilot study and retrospective chart review comparing adalimumab, infliximab, and etanercept in patients with active rheumatoid arthritis

Abstract

Introduction: Rheumatoid Arthritis (RA) can be a very debilitating disease, as it causes pain and fatigue associated with inflammation and destruction of multiple joints. Fortunately, newer classes of drugs called tumor necrosis factor inhibitors (TNF-Is) have been proven effective in reducing joint destruction and overall disease severity. However, it is not known which of these TNF-Is is most efficacious. Methods: This retrospective chart review study compares three TNF-Is: Adalimumab (Humira), Infliximab (Remicade), and Etanercept (Enbrel) through a retrospective chart review completed at Arthritis and Rheumatology Clinics of Kansas in Wichita, Kansas. The study analyzed the pain score, fatigue score, and Health Assessment Questionnaire (HAQ) score for 45 women between the ages 35-65 with active RA who were taking one of the three medications mentioned above. Results: One-way ANOVA tests were performed to evaluate the change in pain, fatigue, and HAQ scores for each of the three drugs over one year. The change, or delta, for pain was R=1.673, E=.688, H=-2.136. The delta values for fatigue were all negative except R=.750. The p value for delta HAQ was p=.082. The mean ages for all three drugs were not significantly different. Conclusion: Remicade was the most efficacious drug when considering improvement in pain. The improvement of HAQ scores were not significantly different between the three drugs. A larger sample size and a longer period of time is needed if future research is done to validate research results