Tsutomu Takeuchi1, Nobuyuki Miyasaka2, Takashi Inui2, Toshiro Yano2, Toru Yoshinari2, Tohru Abe2, Takao Koike2. 1. From the Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University; Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo; Mitsubishi Tanabe Pharma Corporation, Osaka; Saitama Medical Center, Saitama Medical University, Saitama; and the Sapporo Medical Center NTT EC, Hokkaido, Japan.T. Inui, T. Yano, and T. Yoshinari are employees of Mitsubishi Tanabe Pharma. T. Takeuchi, MD, PhD, Professor, Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University; N. Miyasaka, MD, PhD, Professor Emeritus, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; T. Inui, DVM; T. Yano, PhD; T. Yoshinari, MS, Mitsubishi Tanabe Pharma Corporation; T. Abe, MD, PhD, Professor Emeritus, Saitama Medical Center, Saitama Medical University; T. Koike, MD, PhD, Chief Executive, Sapporo Medical Center NTT EC. tsutake@z5.keio.jp. 2. From the Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University; Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo; Mitsubishi Tanabe Pharma Corporation, Osaka; Saitama Medical Center, Saitama Medical University, Saitama; and the Sapporo Medical Center NTT EC, Hokkaido, Japan.T. Inui, T. Yano, and T. Yoshinari are employees of Mitsubishi Tanabe Pharma. T. Takeuchi, MD, PhD, Professor, Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University; N. Miyasaka, MD, PhD, Professor Emeritus, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; T. Inui, DVM; T. Yano, PhD; T. Yoshinari, MS, Mitsubishi Tanabe Pharma Corporation; T. Abe, MD, PhD, Professor Emeritus, Saitama Medical Center, Saitama Medical University; T. Koike, MD, PhD, Chief Executive, Sapporo Medical Center NTT EC.
Abstract
OBJECTIVE: To investigate the probability of clinical remission (REM) or low disease activity (LDA) after 1 year of infliximab (IFX) therapy based on disease activity at 3 months in patients with rheumatoid arthritis (RA). METHODS:Methotrexate-refractory patients with RA received 3 mg/kg of IFX at weeks 0, 2, and 6, followed by 3 mg/kg, 6 mg/kg, or 10 mg/kg every 8 weeks from Week 14 (W14) to Week 46. Correlation of disease activity at W14 with disease activity at W54 and probability of REM/LDA at W54 were analyzed in each dosing group. RESULTS:Disease activities at W14 were significantly correlated with both disease activity at W54 and probability of REM/LDA at W54 in patients continuing 3 mg/kg as well as in those receiving 6 mg/kg or 10 mg/kg therapy from W14. Results showed that, if approximate REM or LDA had not been achieved by W14, > 50% of patients continuing 3 mg/kg therapy would not be able to achieve REM or LDA at W54. However, even in patients with high or moderate disease activity at W14, dose escalation to 6 mg/kg or 10 mg/kg enabled many to achieve REM/LDA. CONCLUSION:Disease activity at W14 in standard-dose IFX therapy enabled the prediction of longterm clinical response at continued standard dose, as well as subsequent escalated-dose regimens. Disease activity at W14 was hypothesized to be an important index for IFX treatment strategy.
RCT Entities:
OBJECTIVE: To investigate the probability of clinical remission (REM) or low disease activity (LDA) after 1 year of infliximab (IFX) therapy based on disease activity at 3 months in patients with rheumatoid arthritis (RA). METHODS:Methotrexate-refractory patients with RA received 3 mg/kg of IFX at weeks 0, 2, and 6, followed by 3 mg/kg, 6 mg/kg, or 10 mg/kg every 8 weeks from Week 14 (W14) to Week 46. Correlation of disease activity at W14 with disease activity at W54 and probability of REM/LDA at W54 were analyzed in each dosing group. RESULTS: Disease activities at W14 were significantly correlated with both disease activity at W54 and probability of REM/LDA at W54 in patients continuing 3 mg/kg as well as in those receiving 6 mg/kg or 10 mg/kg therapy from W14. Results showed that, if approximate REM or LDA had not been achieved by W14, > 50% of patients continuing 3 mg/kg therapy would not be able to achieve REM or LDA at W54. However, even in patients with high or moderate disease activity at W14, dose escalation to 6 mg/kg or 10 mg/kg enabled many to achieve REM/LDA. CONCLUSION: Disease activity at W14 in standard-dose IFX therapy enabled the prediction of longterm clinical response at continued standard dose, as well as subsequent escalated-dose regimens. Disease activity at W14 was hypothesized to be an important index for IFX treatment strategy.
Authors: Daniel J Lovell; Hermine I Brunner; Andreas O Reiff; Lawrence Jung; Katerina Jarosova; Dana Němcová; Richard Mouy; Christy Sandborg; John F Bohnsack; Dirk Elewaut; Christos Gabriel; Gloria Higgins; Isabelle Kone-Paut; Olcay Y Jones; Veronika Vargová; Elizabeth Chalom; Carine Wouters; Ivan Lagunes; Yanna Song; Alberto Martini; Nicolino Ruperto Journal: RMD Open Date: 2020-07
Authors: D van der Heijde; A Deodhar; R Fleischmann; P J Mease; M Rudwaleit; T Nurminen; O Davies Journal: Arthritis Care Res (Hoboken) Date: 2017-06-02 Impact factor: 4.794