Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Remission Induction by Etanercept (ETN) Plus Methotrexate (MTX) Combination Therapy Versus ETN Monotherapy in Patients with Active Rheumatoid Arthritis Despite MTX Treatment.

Kameda1,  Hideto, Ueki2,  Ukitaka, Saito3,  Kazuyoshi, Nagaoka4,  Shouhei, Hidaka5,  Toshihiko, Atsumi6,  Tatsuya, Tsukano7,  Michishi

Keio University School of Medicine, Tokyo, Japan
Medical Center East, Tokyo Women's Medical University, Tokyo, Japan
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
Tokyo Women's Medical Univ, Shinjuku-ku, Tokyo, Japan
Rheumatic and Collagen Disease Center, Sasebo, Japan
U Occupa & Environ Hlth, Kitakyushu, Japan
Yokohama Minami Kyosai Hospital, Yokohama, Japan
Zenjinkai Shimin-No-Mori-Hospital, Miyazaki, Japan
Hokkaido University, Sapporo, Japan
Kumamoto Hospital, Kumamoto, Japan
Showa University School of Med, Shinagawa-ku Tokyo, Japan
Kobe University Graduate School of Health Science and Medicine/ TThe Center for Rheumatic Diseases, Kobe University Hospital, Kobe, Japan


The JESMR study suggested clinical and radiographic superiority of ETN+MTX combination therapy to ETN monotherapy in patients with active rheumatoid arthritis (RA) despite MTX treatment.


To examine the difference in ACR/EULAR/OMERACT remission rates (Boolean and simplified disease activity index; SDAI) at 52 weeks between ETN+MTX combination versus ETN monotherapy.


Demographic and clinical features between groups at baseline were similar. The rates of tender joint count <= 1, swollen joint count <= 1, physician's global assessment <= 1 and serum C-reactive protein (CRP) <= 1 mg/dl were significantly higher in the E+M group than the E group at week 52. The Boolean and the simplified disease activity index (SDAI) remission rates were 11.6% and 21.7% in the E group, respectively, while those were 21.9% and 32.9% (p=0.12 and p=0.19, respectively, versus the E group) in the E+M group. Non-remission by the Boolean or SDAI in the E group was identified as a high-risk group for radiographic progression by modified total Sharp score (DTSS), while remission in the E+M group resulted in radiographic non-progression.

 ETNETN+MTXp value
% tender joint count <= 135640.0007
% swollen joint count <= 139590.02
% patient's global assessment <=122330.19
% physician's global assessment <=135560.012
% CRP <= 1 (mg/dL)5182<0.0001
% Boolean remission12220.12
% SDAI remission22330.19
DTSS in Boolean remission; mean ± SD1.1 ± 2.40.0 ± 2.90.16
DTSS in Boolean non-remission; mean ± SD4.0 ± 11.11.0 ± 7.20.065
DTSS in SDAI remission; mean ± SD1.8 ± 3.0-0.4 ± 3.80.027
DTSS in SDAI non-remission; mean ± SD4.2 ± 12.01.4 ± 7.50.11
% HAQ-DI <= 0.5 in baseline TSS <= 10067620.63
% HAQ-DI <= 0.5 in baseline TSS > 10021470.054


It is indicated that the continuation of MTX at the commencement of ETN and subsequent remission induction are associated with beneficial clinical and radiographic outcomes even in patients with active RA despite MTX treatment.

To cite this abstract, please use the following information:
Kameda, Hideto, Ueki, Ukitaka, Saito, Kazuyoshi, Nagaoka, Shouhei, Hidaka, Toshihiko, Atsumi, Tatsuya, et al; Remission Induction by Etanercept (ETN) Plus Methotrexate (MTX) Combination Therapy Versus ETN Monotherapy in Patients with Active Rheumatoid Arthritis Despite MTX Treatment. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2194

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