Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Etanercept (ETN) Plus Methotrexate (MTX) Combination Therapy Resulted in a Better Radiographic Outcome Than ETN Monotherapy Even in Patients with Active Rheumatoid Arthritis Despite MTX Treatment: 104-Week Results from the JESMR Study.

Kameda2,  Hideto, Kanbe7,  Katsuaki, Sato7,  Eri, Ueki5,  Yukitaka, Saitoh8,  Kazuyoshi, Nagaoka9,  Shouhei, Hidaka10,  Toshihiko

Hokkaido University Graduate School of Medicine
Zenjinkai Shimin-No-Mori-Hospital
Keio University
Kobe University Hospital
Kumamoto Orthopaedic Hospital
Sasebo Chuo Hospital
Showa University School of Medicine
Tokyo Women's Medical University Medical Center
University of Occupational and Environmental Health
Yokohama Minami Kyosai Hospital

Background:

The radiographic superiority of the continuation of methotrexate (MTX) to its discontinuation at the commencement of etanercept (ETN) in patients with active rheumatoid arthritis (RA) despite MTX therapy has not been clarified.

Objectives:

An important aim of the JESMR study is to compare the radiographic efficacy of continuation versus discontinuation of MTX at the commencement of ETN for two years in patients with active RA despite MTX therapy.

Methods:

In total, 151 patients with active RA despite treatment with MTX were randomized to either ETN 25 mg twice a week with 6–8 mg/week of MTX (the E+M group), or ETN alone (the E group). The radiographic progression was assessed by van der Heijde-modified Sharp score at baseline, weeks 24, 52 and 104. The last observation carried forward and linear imputation were used for the analysis of clinical and radiographic efficacy, respectively, for missing data.

Results:

Demographic and clinical features between groups at baseline were similar. The cumulative probability plot of ACR-N at week 104 clearly demonstrated the superior response in the E+M group to that in the E group. The ACR 20, 50 and 70 response rates at week 52 were 82.2%, 68.5% and 46.6%, respectively, in the E+M group, all of which were significantly greater than 59.4% (p=0.003), 39.1% (p=0.001) and 23.2% (p=0.005), respectively, in the E group. The mean progression in total score (DTSS) tended to be smaller in the E+M group than in the E group (1.2 versus 6.6, p=0.09), and a significant difference was observed in the erosion score change at week 104 (-0.5 versus 3.1, respectively, p=0.045). Furthermore, ACR-N < 50 predicted a risk for radiographic progression only in the E group.

Figure 1.

Figure 2.

Conclusion:

The continuation of MTX at the commencement of ETN therapy is clinically and radiographically beneficial even in RA patients who had shown an inappropriate response to MTX.

To cite this abstract, please use the following information:
Kameda, Hideto, Kanbe, Katsuaki, Sato, Eri, Ueki, Yukitaka, Saitoh, Kazuyoshi, Nagaoka, Shouhei, et al; Etanercept (ETN) Plus Methotrexate (MTX) Combination Therapy Resulted in a Better Radiographic Outcome Than ETN Monotherapy Even in Patients with Active Rheumatoid Arthritis Despite MTX Treatment: 104-Week Results from the JESMR Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1812
DOI: 10.1002/art.29577

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