Sustained Remission with Etanercept Tapering in Early Rheumatoid Arthritis
| Autor: | Bernard Combe, Marek Krogulec, Mohammed Hammoudeh, Stefanie Gaylord, Paul Emery, Bonnie Vlahos, Theresa Williams, Emilio Martín-Mola, Maya H Buch, Ronald Pedersen, Oliver FitzGerald, Jack F. Bukowski |
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| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | New England Journal of Medicine. 371:1781-1792 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejmoa1316133 |
| Popis: | BACKGROUND We assessed the effects of reduction and withdrawal of treatment in patients with rheumatoid arthritis who had a remission while receiving etanercept-plus-methotrexate therapy. METHODS Patients with early active disease who had not previously received methotrexate or biologic therapy received 50 mg of etanercept plus methotrexate weekly for 52 weeks (open-label phase). We then randomly assigned patients who had qualifying responses at weeks 39 and 52 to receive 25 mg of etanercept plus methotrexate (combination-therapy group), methotrexate alone, or placebo for 39 weeks (doubleblind phase). Patients who had qualifying responses at week 39 of the double-blind phase had all treatment withdrawn at that time and were followed to week 65 (treatment-withdrawal phase). The primary end point was the proportion of patients with sustained remission in the double-blind phase. RESULTS Of 306 patients enrolled, 193 underwent randomization in the double-blind phase; 131 qualified for the treatment-withdrawal phase. More patients in the combination-therapy group than in the methotrexate-alone group or the placebo group met the criterion for the primary end point (40 of 63 [63%] vs. 26 of 65 [40%] and 15 of 65 [23%], respectively; P = 0.009 for combination therapy vs. methotrexate alone; P |
| Databáze: | OpenAIRE |
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