Less Radiographic Progression with Adalimumab Plus Methotrexate Versus Methotrexate Monotherapy Across the Spectrum of Clinical Response in Early Rheumatoid Arthritis
| Autor: | John T Sharp, Ronald F van Vollenhoven, Kaushik Patra, Paul Emery, Mark C. Genovese, E.H. Sasso |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty medicine.drug_class Immunology Arthritis Antibodies Monoclonal Humanized Severity of Illness Index Gastroenterology Antimetabolite Arthritis Rheumatoid chemistry.chemical_compound Double-Blind Method Rheumatology immune system diseases Internal medicine medicine Adalimumab Humans Immunology and Allergy Longitudinal Studies Arthrography skin and connective tissue diseases Aged business.industry Antibodies Monoclonal Middle Aged medicine.disease Surgery Clinical trial Methotrexate Treatment Outcome chemistry Antirheumatic Agents Rheumatoid arthritis Antifolate Disease Progression Drug Therapy Combination Female Joints business medicine.drug |
| Zdroj: | The Journal of Rheumatology. 36:1429-1441 |
| ISSN: | 1499-2752 0315-162X |
| DOI: | 10.3899/jrheum.081018 |
| Popis: | Objective.To determine the relationship between radiographic progression and clinical response for adalimumab plus methotrexate (MTX) versus either monotherapy in patients with early rheumatoid arthritis (RA) in the PREMIER study.Methods.Patients with early RA who received adalimumab plus MTX (n = 240), adalimumab (n = 222), or MTX (n = 216) were grouped by American College of Rheumatology (ACR) response, 28-joint Disease Activity Score (DAS28), or remission-like state [tender joint count (TJC) = 0; DAS28 < 2.6; swollen joint count = 0; ACR100] at 26 and 104 weeks. Radiographic progression was assessed by cumulative probability plots, mean changes in total Sharp score (ΔTSS), and percentages of progressors (ΔTSS > 0.5).Results.Across the spectrum of clinical outcomes, including ACR20 nonresponses and remission-like responses, therapy with adalimumab plus MTX permitted less radiographic progression at Weeks 26 and 104 than MTX monotherapy. Adalimumab monotherapy was generally intermediate. A strong, proportional relationship was observed between clinical response and radiographic efficacy only for MTX monotherapy. The monotherapies approximated the radiographic efficacy of adalimumab plus MTX only among remission-like responders, although progression was significantly greater with MTX monotherapy versus adalimumab plus MTX for patients with TJC = 0. Concurrent clinical (DAS28 < 2.6) and radiographic (ΔTSS ≤ 0.5) remission was significantly more frequent at Week 104 with adalimumab plus MTX (45%) than with adalimumab (25%) or MTX (18%) monotherapy.Conclusion.In patients with early RA, adalimumab plus MTX resulted in less radiographic progression than MTX monotherapy across the spectrum of clinical response, including ACR20 non-responses and remission-like responses. |
| Databáze: | OpenAIRE |
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