scholarly journals Inhibition of radiographic progression with combination etanercept and methotrexate in patients with moderately active rheumatoid arthritis previously treated with monotherapy

2008 ◽  
Vol 68 (7) ◽  
pp. 1113-1118 ◽  
Author(s):  
D van der Heijde ◽  
G Burmester ◽  
J Melo-Gomes ◽  
C Codreanu ◽  
E M. Mola ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Previously Treated

scholarly journals SAT0146 INHIBITION OF RADIOGRAPHIC PROGRESSION BY IGURATINOD IN 116 JAPANESE RHEUMATOID ARTHIRITIS PATIENTS DESPITE CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS THERAPY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1011.2-1012
Author(s):  
K. Katayama ◽  
T. Okubo ◽  
K. Yujiro ◽  
R. Fukai ◽  
T. Sato ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Disease Duration ◽  
Radiographic Progression ◽  
Controlled Trial ◽  
Joint Destruction ◽  
Inhibitory Effects ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Disease Modifying

Background:Japanese double-blind clinical practice studies of Iguratimod (IGU) for active rheumatoid arthritis (RA) patients indicated an early and sustained efficacy as a new conventional synthetic disease-modyfing anti-rheumatic drugs (csDMARDs) [1] as well as the safety of the treatment[2]. IGU also inhibit activation of NFkB and production of RANKL, indicating strong inhibiting activity against bone destruction. However, studies focused on the inhibitory effects of joint destruction by IGU has been poorly documented in clinical practice (3).Objectives:To evaluate inhibitory effect during 1 year by additional IGU therapy in 116 RA patients despite csDMARDs therapy.Methods:Inhibitory effects of joint damage were evaluated by modified total Sharp scoring (mTSS) at baseline and 1 year after IGU prescription. RA activity was measured by DAS28-ESR.Results:The subjects were 116 cases, 30 male, age 63.2 yrs, disease duration 93.7 months. MTX was used weekly (84 cases, 72.4%), and cs DMARDs were used as BUC 43 cases, SASP 13 cases, TAC 5 cases, and LEF 1 cases. bDMARDs were used even in 8 cases, and steroids were used in 3.9 mg (70 cases, 60.3 %). Complications were observed in 70 cases (60.3%). DAS28-ESR were significantly improved from 4.29 (baseline) to 3.65 (6 months), 3.68 (12 months), respectively (P<0.0001). As shown in Figure 1, joint destruction measured by mTSS was significantly suppressed from 7.74 to 0.57 at 1 year (P<0.0001). 70.6% of patients satisfied structural remission (ΔmTSS≤0.5). Clinically relevant radiographic progression (CRRP)(mTSS>3) was observed in 10 cases (8.6%), and rapid radiographic progression(RRP) (mTSS≥5) was observed in 2 cases (1.6%). Adverse events were observed in 26 cases (22.4 %).To investigate prognostic factor for CRRP, clinical data in baseline, 6, 12 months between ten patients with CRRP and 82 patients with structural remission were compared. As shown in Table 1, longer disease duration, more SJC (P<0.05), High CRP level(P<0.005) were prognostic for CRRP in IGU treated patients.Conclusion:Iguratimod suppressed not only clinical activities but also joint destruction in RA patients resistant to csDMARDs therapy.Table 1. Prognostic factor for CRRPReferences:[1]Ishiguro N, Yamamoto K, Katayama K et al. Concomitant iguratimod therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate a randomized, double-blind, placebo-controlled trial. Mod Rheumatol. 2013;23(3):430-9[2]Hara M, Ishiguro N, Katayama K et al. Safety and efficacy of combination therapy of iguratimod with methotrexate for patients with active rheumatoid arthritis with an inadequate response to methotrexate: an open-level extension of a randomized, double-blind, placebo-controlled trial. Mod Rheumatol. 2014;24(3):410–8.[3]Ishikawa K, Ishikawa J.Iguratimod, a synthetic disease modifying anti-rheumatic drug inhibiting the activation of NF-jB and production of RANKL: Its efficacy, radiographic changes,safety and predictors over two years’ treatment for Japanese rheumatoid arthritis patients. Mod.Rheumatol.2019,29(3), 418–429.Disclosure of Interests:None declared

scholarly journals Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xue-Pei Zhang ◽  
Jian-Da Ma ◽  
Ying-Qian Mo ◽  
Jun Jing ◽  
Dong-Hui Zheng ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Stromal Cell ◽  
Active Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Positive Staining ◽  
Cell Markers ◽  
Treatment Naïve ◽  
Modified Total Sharp Score

ObjectivesThis study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA).MethodsActive RA patients with a knee needle synovial biopsy at baseline and finished 1-year follow-up were recruited from a real-world prospective cohort. Positive staining for CD20, CD38, CD3, CD68, CD31, and CD90 were scored semiquantitatively (0-4). The primary outcome was radiographic progression defined as a minimum increase of 0.5 units of the modified total Sharp score from baseline to 1 year.ResultsAmong 150 recruited RA patients, 123 (82%) had qualified synovial tissue. Higher scores of CD20+ B cells, sublining CD68+ macrophages, CD31+ endothelial cells, and CD90+ fibroblasts were associated with less decrease in disease activity and greater increase in radiographic progression. A new fibroblast-based classification of synovial pathotypes giving more priority to myeloid and stromal cells classified samples as myeloid-stromal (57.7%, 71/123), lymphoid (31.7%, 39/123), and paucicellular pathotypes (10.6%, 13/123). RA patients with myeloid-stromal pathotype showed the highest rate of radiographic progression (43.7% vs. 23.1% vs. 7.7%, p = 0.011), together with the lowest rate of Boolean remission at 3, 6, and 12 months. Baseline synovial myeloid-stromal pathotype independently predicted radiographic progression at 1 year (adjusted OR: 3.199, 95% confidence interval (95% CI): 1.278, 8.010). Similar results were obtained in a subgroup analysis of treatment-naive RA.ConclusionsThis novel fibroblast-based myeloid-stromal pathotype could predict radiographic progression at 1 year in active RA patients which may contribute to the shift of therapeutic decision in RA.

scholarly journals Radiographic progression of structural joint damage over 5 years of baricitinib treatment in patients with rheumatoid arthritis: Results from RA-BEYOND

2021 ◽  
pp. jrheum.210346
Author(s):  
Désirée van der Heijde ◽  
Cynthia E. Kartman ◽  
Li Xie ◽  
Scott Beattie ◽  
Douglas Schlichting ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Joint Damage ◽  
Inadequate Response ◽  
Once Daily ◽  
Link Type ◽  
Structural Joint ◽  
Modified Total Sharp Score

Objective To evaluate the effect of baricitinib on inhibiting radiographic progression of structural joint damage over 5 years in patients with active rheumatoid arthritis (RA). Methods Patients completed 1 of 3 phase 3 baricitinib trials (NCT01711359, NCT01710358, NCT01721057) and entered the long-term extension RA-BEYOND (NCT01885078), in which patients received once-daily 4 mg or 2 mg baricitinib. Across these trials, patients initially receiving methotrexate (MTX) or adalimumab switched to baricitinib 4 mg at week 52. Patients initially receiving placebo switched to baricitinib 4 mg at week 24. Radiographs were scored at baseline and years 2, 3, 4, and 5. Change from baseline in van der Heijde modified Total Sharp Score (ΔmTSS) was computed. Results Overall, 2125/2573 (82.6%) randomized patients entered RA-BEYOND; 1837/2125 (86.4%) entered this analysis. From years 3 to 5, higher proportions of DMARD-naïve patients on initial baricitinib (monotherapy; +MTX) had no progression versus initial MTX (ΔmTSS≤0, year 5: 59.6% baricitinib 4 mg; 66.2% baricitinib 4 mg+MTX; 40.7% MTX). Higher proportions of patients with inadequate response (IR) to MTX on initial baricitinib or adalimumab versus placebo had no progression (ΔmTSS≤0, year 5: 54.8% baricitinib 4 mg; 55.0% adalimumab; 50.3% placebo). Higher proportions of patients with conventional synthetic (cs)DMARD-IR on initial baricitinib 4 mg had less progression versus initial placebo or baricitinib 2 mg (ΔmTSS≤0, year 5: 66.7% baricitinib 4 mg; 58.2% baricitinib 2 mg; 60.0% placebo). Conclusion Oral baricitinib maintained lower levels of radiographic progression than initial csDMARD or placebo through 5 years in patients with active RA.

scholarly journals Continuation of Methotrexate Resulted in Better Clinical and Radiographic Outcomes Than Discontinuation upon Starting Etanercept in Patients with Rheumatoid Arthritis: 52-week Results from the JESMR Study

2011 ◽  
Vol 38 (8) ◽  
pp. 1585-1592 ◽  
Author(s):  
HIDETO KAMEDA ◽  
KATSUAKI KANBE ◽  
ERI SATO ◽  
YUKITAKA UEKI ◽  
KAZUYOSHI SAITO ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Cumulative Probability ◽  
Link Type ◽  
American College Of Rheumatology ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
The Mean ◽  
Better Than

Objective.The aim of the Efficacy and Safety of Etanercept on Active Rheumatoid Arthritis Despite Methotrexate Therapy in Japan (JESMR) study is to compare the efficacy of continuation versus discontinuation of methotrexate (MTX) when starting etanercept (ETN) in patients with active rheumatoid arthritis (RA).Methods.In total, 151 patients with active RA who had been taking MTX were randomized to either ETN 25 mg twice a week with 6–8 mg/week MTX (the E+M group), or ETN alone (the E group). The primary endpoint at Week 52 was the radiographic progression assessed by van der Heijde-modified Sharp score.Results.The mean progression in total score at Week 52 was not significantly different, statistically, between the E+M group and the E group (0.8 vs 3.6, respectively; p = 0.06). However, a significant difference was observed in radiographic progression between Weeks 24 and 52 (0.3 vs 2.5; p = 0.03), and the mean progression of the erosion score was negative in the E+M group, which was significantly better than the E group at Week 52 (–0.2 vs 1.8; p = 0.02). Clinically, the cumulative probability plot of the American College of Rheumatology (ACR)-N values at Week 52 clearly demonstrated a superior response in the E+M group than in the E group. ACR20, 50, and 70 response rates at Week 52 in the E+M group (86.3%, 76.7%, and 50.7%) were significantly greater than those in the E group (63.8%; p = 0.003, 43.5%; p < 0.0001 and 29.0%; p = 0.01, respectively).Conclusion.MTX should be continued when starting ETN in patients with active RA. (ClinicalTrials.gov: NCT00688103)

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