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The study involved the comparisons of responses among the early rheumatoid arthritis (RA) patients initially operated with MTX monotherapy versus adalimumab+methotrexate (MTX) who may have sustained taking MTX or shifted to adalimumab rescue therapy following poor response to MTX.
Disease-modifying
antirheumatic drugs (DMARDs), especially methotrexate (MTX) are the most
recommended treatment for Rheumatoid Arthritis (RA). If the patient activity is
not improved after three months of treatment, the addition of a biological
DMARD (bDMARD), such as a tumor necrosis factor inhibitor (TNFi), is
recommended. Therefore, in the present research, the authors revealed that the
combination of adalimumab and MTX prevented potential overtreatment of
approximately 25% of patients with early RA.
The study involved the comparisons of responses among the early rheumatoid
arthritis (RA) patients initially operated with MTX monotherapy versus
adalimumab+methotrexate (MTX) who may have sustained taking MTX or shifted to
adalimumab rescue therapy following poor response to MTX.
MTX-naive patients with progressive RA for <1 year was selected by
OPTIMA which analyzed patients who were at their initial treatment stage and
showed <3.2 28-joint modified Disease Activity Score with no radiographic
improvement at weeks 26, 52 and 78.
The higher proportion of patients of initially treated adalimumab+ MTX
showed considerably excellent functional, clinical and radiographic outcomes at
week 26 as compared to MTX monotherapy. Further, patients under
adalimumab-rescue obtained identical functional and clinical results than
patients initially managed with adalimumab+MTX from 26 to 78 weeks. Although,
considerably more patients initially dosed with adalimumab+MTX had no
radiographic improvement at weeks 52 and 78 as compared to patients initially
treated with MTX.
The patients with early RA who
initiated MTX monotherapy and including
TNFi following 26 weeks showed similar longer-term clinical results as starting
with TNFi+MTX combination treatment, however, allow a small but important
accrual of radiographic damage.
Ann Rheum Dis. 2017 Nov 16
Testing treat-to-target outcomes with initial methotrexate monotherapy compared with initial tumour necrosis factor inhibitor (adalimumab) plus methotrexate in early rheumatoid arthritis
Arthur Kavanaugh et al.
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