Testing Treat-to-Target Outcomes With Initial Methotrexate Monotherapy Compared With Initial Tumor Necrosis Factor Inhibitor (Adalimumab) Plus Methotrexate in Early Rheumatoid Arthritis

Autor: Ronald F van Vollenhoven, I. Sainsbury, Stefan Florentinus, Benoît Guérette, Josef S Smolen, Paul Emery, Arthur Kavanaugh, Hartmut Kupper, Su Chen, Roy Fleischmann
Přispěvatelé: AII - Inflammatory diseases, Clinical Immunology and Rheumatology, Amsterdam Movement Sciences, Amsterdam institute for Infection and Immunity, Rheumatology, CCA - Cancer immunology
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
musculoskeletal diseases
medicine.medical_specialty
Necrosis
Immunology
early rheumatoid arthritis
anti-tnf
Severity of Illness Index
Gastroenterology
methotrexate
General Biochemistry
Genetics and Molecular Biology
Arthritis
Rheumatoid
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Rheumatology
Rescue therapy
Internal medicine
Early ra
Adalimumab
medicine
Humans
Immunology and Allergy
In patient
skin and connective tissue diseases
030203 arthritis & rheumatology
treatment
Tumor Necrosis Factor-alpha
business.industry
Treat to target
Early rheumatoid arthritis
Clinical and Epidemiological Research
Surgery
Treatment Outcome
030104 developmental biology
Antirheumatic Agents
Drug Therapy
Combination
Methotrexate
medicine.symptom
business
disease activity
medicine.drug
Zdroj: Kavanaugh, A, van Vollenhoven, R F, Fleischmann, R, Emery, P, Sainsbury, I, Florentinus, S, Chen, S, Guérette, B, Kupper, H & Smolen, J S 2018, ' Testing treat-to-target outcomes with initial methotrexate monotherapy compared with initial tumour necrosis factor inhibitor (adalimumab) plus methotrexate in early rheumatoid arthritis ', Annals of the Rheumatic Diseases, vol. 77, no. 2, pp. 289-292 . https://doi.org/10.1136/annrheumdis-2017-211871
Annals of the rheumatic diseases, 77(2), 289-292. BMJ Publishing Group
Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases, 77(2), 289-292. BMJ Publishing Group
ISSN: 0003-4967
Popis: ObjectivesTo compare responses in patients with early rheumatoid arthritis (RA) initially treated with the tumour necrosis factor inhibitor (TNFi) adalimumab+methotrexate (MTX) versus MTX monotherapy who may have continued receiving MTX or switched to adalimumab rescue therapy after inadequate response to MTX.MethodsOPTIMA enrolled MTX-naive patients with active RA for ResultsSignificantly greater proportions of patients initially treated with adalimumab+MTX (n=466) compared with MTX monotherapy (n=460) achieved good clinical (53% vs 30%), functional (45% vs 33%) and radiographic (87% vs 72%) outcomes at week 26. From weeks 26 to 78, adalimumab rescue patients achieved similar clinical and functional outcomes versus patients initially treated with adalimumab+MTX. However, significantly more patients initially treated with adalimumab+MTX had no radiographic progression at weeks 52 and 78 versus patients initially treated with MTX (both timepoints: 86% vs 72%).ConclusionsIn early RA, starting with MTX monotherapy and adding TNFi after 26 weeks yields similar longer term clinical results as starting with TNFi+MTX combination therapy but allows a small but significant accrual of radiographic damage.
Databáze: OpenAIRE
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