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Etanercept/MTX therapy more effective than DMARD/MTX in RA patients
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Patients with rheumatoid arthritis who had an inadequate response to methotrexate displayed higher efficacy to treatment of etanercept plus methotrexate when compared with a disease-modifying antirheumatic drug added to methotrexate, according to recent study results.
Researchers conducted an open-label, multicenter study of patients with moderate to severe rheumatoid arthritis (RA; mean age, 48.5 years; 89% women) despite methotrexate (MTX) therapy. Patients from five Latin American countries were randomly assigned 50 mg etanercept weekly plus MTX (n=281) or an investigator-selected disease-modifying antirheumatic drug (DMARD; sulfasalazine or hydroxychloroquine) plus MTX (n=142). Proportion of patients receiving American College of Rheumatology 50% response (ACR50) at week 24 was the primary endpoint. ACR 20/70, Disease Activity Score 28 (DAS28) and mean change in modified Total Sharp Score (mTSS) were secondary endpoints.
ACR50 was achieved by 62% of patients treated with ETN/MTX compared with 23% of patients treated with DMARD/MTX. Etanercept-treated patients also had greater achievement of secondary endpoints (P<.0001 for all). The ETN/MTX cohort had a greater mean change in mTSS (0.4 vs. 1.4; P=0.27).
Patient-reported outcomes for Health Assessment Questionnaire, 36-item Short Form, Hospital Anxiety and Depression Scale for Depression, Work Productivity and Activity Impairment: RA, and Caregiver Burden and Resource Utilization ED visits for RA also were greater for the ETN/MTX cohort (P<.01).
Adverse events and serious adverse events were similar across both cohorts (69% and 3.6%, respectively, for ETN/MTX vs. 68% and 1.4% for DMARD/MTX). ETN/MTX patients, however, had more overall infections (38% vs. 22%; P≤.001).
“Consistent with published global data among RA patients with inadequate response to MTX, adding ETN to MTX demonstrated better efficacy than adding one other conventional DMARD to MTX,” the researchers concluded.
Disclosure: See the study for a full list of relevant financial disclosures.
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