Inhibition of radiographic progression with combination etanercept and methotrexate in patients with moderately active rheumatoid arthritis previously treated with monotherapy
van der Heijde, D.; Burmester, G.; Melo-Gomes, J.et al.
2009 • In Annals of the Rheumatic Diseases, 68 (7), p. 1113-1118
[en] OBJECTIVE: To determine the effect of changing from etanercept or methotrexate
monotherapy to etanercept plus methotrexate combination therapy on radiographic
progression in rheumatoid arthritis (RA) patients. METHODS: Patients enrolled in
this 1-year open-label study previously completed a 3-year blinded study in which
they received methotrexate or etanercept monotherapy or the combination of both.
All patients received the combination of etanercept 25 mg subcutaneously twice
weekly plus oral methotrexate up to 20 mg/week. The primary radiographic endpoint
was a change in modified total Sharp score (TSS), as assessed by blinded readers.
RESULTS: At baseline, patients previously receiving methotrexate monotherapy
(etanercept-added, n = 52) or etanercept monotherapy (methotrexate-added, n = 68)
had moderate disease activity levels (mean disease activity score (DAS) of 2.6
and 2.5, respectively), whereas patients previously receiving combination therapy
(n = 90) had a low disease activity level (mean DAS of 2.0). The addition of
etanercept to methotrexate monotherapy resulted in a significant reduction in
radiographic progression (p<0.05). Mean TSS changes in the previous year versus
the current year were +1.79 versus +0.25 for the etanercept-added group (p<0.05);
+0.51 versus -0.18 for the methotrexate-added group (NS) and +0.42 versus +0.24
for the combination group (NS). CONCLUSION: In these RA patients with on average
moderate disease activity despite previous methotrexate monotherapy, combination
treatment with etanercept and methotrexate inhibited radiographic progression and
improved radiographic outcomes. These data, in conjunction with the previously
published clinical data, support the use of combination therapy in RA patients
with moderate disease activity.
Disciplines :
Rheumatology
Author, co-author :
van der Heijde, D.
Burmester, G.
Melo-Gomes, J.
Codreanu, C.
Martin Mola, E.
Pedersen, R.
Robertson, D.
Chang, D.
Koenig, A.
Malaise, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Rhumatologie
Freundlich, B.
Language :
English
Title :
Inhibition of radiographic progression with combination etanercept and methotrexate in patients with moderately active rheumatoid arthritis previously treated with monotherapy
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