Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry

2012 ◽  
Vol 72 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Lykke Midtbøll Ørnbjerg ◽  
Mikkel Østergaard ◽  
Pernille Bøyesen ◽  
Niels Steen Krogh ◽  
Anja Thormann ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Tumour Necrosis Factor ◽  
Tumour Necrosis ◽  
Radiographic Progression ◽  
Tumour Necrosis Factor Inhibitor ◽  
Factor Inhibitor ◽  
Necrosis Factor ◽  
Inhibitor Treatment

scholarly journals Testing treat-to-target outcomes with initial methotrexate monotherapy compared with initial tumour necrosis factor inhibitor (adalimumab) plus methotrexate in early rheumatoid arthritis

2017 ◽  
Vol 77 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Arthur Kavanaugh ◽  
Ronald F van Vollenhoven ◽  
Roy Fleischmann ◽  
Paul Emery ◽  
Iain Sainsbury ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumour Necrosis Factor ◽  
Early Rheumatoid Arthritis ◽  
Tumour Necrosis ◽  
Radiographic Progression ◽  
Tumour Necrosis Factor Inhibitor ◽  
Treat To Target ◽  
Inadequate Response ◽  
Factor Inhibitor ◽  
Necrosis Factor

ObjectivesTo compare responses in patients with early rheumatoid arthritis (RA) initially treated with the tumour necrosis factor inhibitor (TNFi) adalimumab+methotrexate (MTX) versus MTX monotherapy who may have continued receiving MTX or switched to adalimumab rescue therapy after inadequate response to MTX.MethodsOPTIMA enrolled MTX-naive patients with active RA for <1 year. This post hoc analysis determined the proportion of patients, stratified by initial treatment, who achieved 28-joint modified Disease Activity Score based on C reactive protein <3.2, normal function and/or no radiographic progression at weeks 26, 52 and 78.ResultsSignificantly greater proportions of patients initially treated with adalimumab+MTX (n=466) compared with MTX monotherapy (n=460) achieved good clinical (53% vs 30%), functional (45% vs 33%) and radiographic (87% vs 72%) outcomes at week 26. From weeks 26 to 78, adalimumab rescue patients achieved similar clinical and functional outcomes versus patients initially treated with adalimumab+MTX. However, significantly more patients initially treated with adalimumab+MTX had no radiographic progression at weeks 52 and 78 versus patients initially treated with MTX (both timepoints: 86% vs 72%).ConclusionsIn early RA, starting with MTX monotherapy and adding TNFi after 26 weeks yields similar longer term clinical results as starting with TNFi+MTX combination therapy but allows a small but significant accrual of radiographic damage.

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