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Background In patients (pts) with rheumatoid arthritis (RA), the long-term impact of sustained versus (vs) transient clinical remission (REM) has not been assessed thoroughly, although REM duration has been shown to affect structural outcomes 1 . The relationship of different definitions of clinical remission (REM) with function and structural integrity has not been assessed. Objectives To explore the importance of sustained REM or disease control for long-term outcomes, and assess various definitions of REM in adalimumab (ADA) long-term trials. Methods Data are from 2 trials of ADA in early RA pts; In PREMIER, pts received ADA, methotrexate (MTX) or ADA+MTX for 2 years (yrs), after which they could enter an open label (OL) period for upto 8 yrs 2 . In OPTIMA, pts received ADA+MTX, or placebo (PBO) +MTX for 26 weeks (wks). Based on whether or not pts achieved DAS28-CRP 3 . For this analysis, non-sustained REM/disease control was defined as meeting one of the following at 6 months but not 1 yr: DAS28-CRP Results In OPTIMA, by any of the REM criteria, pts in sustained REM had larger mean ΔHAQ-DI over time (Fig 1A) vs pts in non-sustained REM. Pts with non-sustained DAS28-CRP Conclusions Pts who were in sustained disease control/REM had better clinical, functional and radiographic outcomes over the long- term, vs pts in a more transient state, regardless of the REM criteria used, although for CDAI REM, functional and radiographic outcomes were similar for sustained and non-sustained REM, in line with its higher stringency. References Aletaha et al, Arthritis & Rheum. 2009;5:1242. Breedveld et al. 2006. Arthritis & Rheum;54:26. Smolen et al. 2014. Lancet;383:321. Acknowledgements AbbVie: study sponsor, contributed to design, data collection, analysis, interpretation; and writing, reviewing, approval of final version. Medical writing: Naina Barretto, of AbbVie. Disclosure of Interest J. Smolen: None declared, C. Gabay Grant/research support from: AbbVie Inc, Amgen, BMS, MSD, Pfizer, Roche, Celgene, Sanofi, and Regeneron., Consultant for: AbbVie Inc, Amgen, BMS, MSD, Pfizer, Roche, Celgene, Sanofi, and Regeneron., D. Aletaha Grant/research support from: AbbVie Inc., Pfizer, Grunenthal, Merck, Medac, UCB, Mitsubishi/Tanabe, Janssen, and Roche., Consultant for: AbbVie Inc., Pfizer, Grunenthal, Merck, Medac, UCB, Mitsubishi/Tanabe, Janssen, and Roche., P. Emery Grant/research support from: research grants and consulting fees from Pfizer, MSD, AbbVie Inc., Bristol-Myers Squibb, UCB, Roche, Novartis, Samsung, Sandoz and Lilly., Consultant for: research grants and consulting fees from Pfizer, MSD, AbbVie Inc., Bristol-Myers Squibb, UCB, Roche, Novartis, Samsung, Sandoz and Lilly., I. Sainsbury Employee of: AbbVie, Y. Zhang Employee of: AbbVie, A. Kavanaugh Grant/research support from: AbbVie Inc., Amgen, Astra-Zeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, and UCB., Consultant for: AbbVie Inc., Amgen, Astra-Zeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, and UCB. |
