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High disease activity, less treatment improvement predicted lower RA remission rates
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In patients with rheumatoid arthritis, high disease activity and less improvement with treatment over time in the initial 24 weeks of treatment predicted lower remission rate at 1 year, according to study results.
Researchers randomly assigned patients with moderate-to-severe rheumatoid arthritis of 3 to 24 months’ duration to receive etanercept (ETN) 50 mg weekly plus methotrexate (MTX) or MTX monotherapy for 52 weeks. To evaluate the likelihood of remission after 1 year despite poor clinical short-term treatment effects, the researchers performed regression analyses.
Study results showed remission probability was influenced by the magnitude of disease activity and its improvement and timing in both treatment groups. However, higher disease activity levels and lower response levels diminished remission rate over time from weeks 4 to 24, according to the researchers.
Compared with MTX alone at most time points from weeks 4 to 24, patients in the ETN/MTX group generally had a greater rate of 28-joint Disease Activity Score-Erythrocyte Sedimentation Rate (DAS28-ESR) remission at 1 year.
After 1 year of continuous treatment, the researchers found 35% of patients in the ETN/MTX group achieved DAS28-ESR remission despite persistent high disease activity after 4 weeks of therapy. This rate was continued with 27% of patients in the ETN/MTX group after 8 weeks of therapy; 25% of patients after 12 weeks of therapy; and 22% of patients after 24 weeks of therapy.
In the MTX group, the percentage of DAS28-ESR remission was 33% at 4 weeks of therapy; 27% at 8 weeks; 8% at 12 weeks; and 13% at 24 weeks.
Disclosure: See the full study for all authors’ relevant financial disclosures.
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