This article is more than 5 years old. Information may no longer be current.
Low disease activity persists for some patients with RA after halting adalimumab
A large proportion of patients with rheumatoid arthritis remained in a state of low disease activity after discontinuation of adalimumab, while continuing methotrexate as a monotherapy, according to recently published research.
Researchers studied 220 patients with rheumatoid arthritis (RA) who participated in the HOPEFUL-2 study following enrollment in HOPEFUL-1, a double-blind, placebo-controlled trial of adalimumab in combination with methotrexate for patients with early rheumatoid arthritis who were methotrexate-naïve. Patients were assessed with the DAS28, Health Assessment Questionnaire – Disability Index and the modified total Sharp Score (mTSS). Low disease activity was defined as DAS28 based on a C-reactive protein (DAS28-CRP) level below 3.2, and the absence of radiographic progression was defined as an mTSS of 0.5 or less. Remission was defined as a DAS-CRP of less than 2.6.
Of the 220 patients, 114 discontinued adalimumab (Humira, AbbVie) and remained on methotrexate as a monotherapy and 106 patients continued adalimumab in addition to methotrexate. The 52-week extension study was completed by 65 patients who continued adalimumab and 92 patients in the methotrexate monotherapy group.
At HOPEFUL-2 baseline, the mean DAS28-CRP was 2.1 among patients who discontinued adalimumab and 2.2 among patients who continued adalimumab treatment. At week 104, the mean DAS28-CRP was 2.5 in patients who discontinued adalimumab and 2 in the group that continued treatment.
Clinical remission was observed in 60.4% of patients who discontinued adalimumab and in 74% of patients who remained on the biologic, while low disease activity was observed in 76.1% and 91.3%, respectively. – by Shirley Pulawski
Disclosures: Tanaka has received consulting fees, speaking fees and/or honoraria from AbbVie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-Kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD and Santen, as well as research grants from Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, Taisho-Toyama, Kyowa-Kirin, AbbVie and Bristol-Myers. Please see the full study for a list of all other authors’ relevant financial disclosures.