OBJECTIVE: To ascertain whether a 1-year remission induction therapy with an infliximab-MTX (INF-MTX) combination in patients with early RA provided sustained benefit after INF cessation compared with conventional treatment. METHODS:Twenty patients with poor prognosis RA of < 1 year of disease duration were randomized to receive either INF and MTX or placebo infusions and MTX for 1 year. They then stepped down to MTX monotherapy and were treated according to standard clinical care. After 8 years, disease activity, function and quality of life (QoL) data were collected. RESULTS: At follow-up, data were available for 18 patients (1 in each group had died). Median 28-joint DAS was significantly lower in the INF-MTX group compared with placebo-MTX group (2.7 vs 4.3, P = 0.02). Four patients in the INF-MTX group were in remission vs none in the placebo-MTX group. One patient in the INF-MTX group achieved drug-free remission. Both RAQoL and HAQ median scores were lower in the INF-MTX group; however, this did not reach statistical significance (median RAQoL 3 vs 8, P = 0.18; median HAQ 1.0 vs 1.5, P = 0.12). CONCLUSION: A remission induction regime with an INF-MTX combination for 1 year in early RA can improve long-term clinical outcomes. Larger studies will be required to confirm the implications of these findings.
RCT Entities:
OBJECTIVE: To ascertain whether a 1-year remission induction therapy with an infliximab-MTX (INF-MTX) combination in patients with early RA provided sustained benefit after INF cessation compared with conventional treatment. METHODS: Twenty patients with poor prognosis RA of < 1 year of disease duration were randomized to receive either INF and MTX or placebo infusions and MTX for 1 year. They then stepped down to MTX monotherapy and were treated according to standard clinical care. After 8 years, disease activity, function and quality of life (QoL) data were collected. RESULTS: At follow-up, data were available for 18 patients (1 in each group had died). Median 28-joint DAS was significantly lower in the INF-MTX group compared with placebo-MTX group (2.7 vs 4.3, P = 0.02). Four patients in the INF-MTX group were in remission vs none in the placebo-MTX group. One patient in the INF-MTX group achieved drug-free remission. Both RAQoL and HAQ median scores were lower in the INF-MTX group; however, this did not reach statistical significance (median RAQoL 3 vs 8, P = 0.18; median HAQ 1.0 vs 1.5, P = 0.12). CONCLUSION: A remission induction regime with an INF-MTX combination for 1 year in early RA can improve long-term clinical outcomes. Larger studies will be required to confirm the implications of these findings.
Authors: Jasvinder A Singh; Alomgir Hossain; Amy S Mudano; Elizabeth Tanjong Ghogomu; Maria E Suarez-Almazor; Rachelle Buchbinder; Lara J Maxwell; Peter Tugwell; George A Wells Journal: Cochrane Database Syst Rev Date: 2017-05-08
Authors: J R Kalden; H Burkhardt; B Buss; U Donhauser-Gruber; U Erstling; E Gromnica-Ihle; K Karberg; T Karger; C H Kneitz; A Krause; K Krüger; H-M Lorenz; U Müller-Ladner; A Rubbert-Roth; P Steffens-Korbanka; H-P Tony; J Wendler; J Wollenhaupt; G Burmester Journal: Z Rheumatol Date: 2011-10 Impact factor: 1.372
Authors: Lise M Verhoef; Bart Jf van den Bemt; Aatke van der Maas; Johanna E Vriezekolk; Marlies E Hulscher; Frank Hj van den Hoogen; Wilco Ch Jacobs; Noortje van Herwaarden; Alfons A den Broeder Journal: Cochrane Database Syst Rev Date: 2019-05-24