Infliximab enhances RA response to methotrexate alone

June 2, 2000

I haven't yet heard about any use of Remicade in children with JRA but

this may one day be another possible treatment option. At least

according to this study, it looks promising.

~Georgina

Infliximab enhances RA response to methotrexate alone

WESTPORT, Jun 02 (Reuters Health) - Multiple doses of the anti-tumor

necrosis factor-alpha monoclonal antibody, infliximab , combined with

methotrexate are effective in controlling active rheumatoid arthritis

for up to 40 weeks, according to a pilot trial conducted at three

medical centers. Dr. Arthur Kavanaugh of the University of California,

San Diego, and colleagues followed 23 patients whose rheumatoid

arthritis remained active despite at least 3 months' treatment with

methotrexate 10 mg/week. While continuing on the methotrexate, patients

received intravenous infusion of infliximab at doses ranging from 5 to

20 mg/kg, at baseline and at weeks 12, 20, and 28.

" A striking feature of the clinical response was its rapidity, " the

investigators report, with 17 patients exhibiting an American College of

Rheumatology 20% response by week 1 or 2. This result, reported in the

April issue of the Journal of Rheumatology, was maintained through week

12 in 11 patients. Only one of the seven placebo-treated patients showed

similar improvement. An ACR 50% response was achieved in 12 patients.

Adverse effects, which were no more than moderate during the first 12

weeks, were unrelated to dosage. One infection requiring hospitalization

was noted. Four patients exhibited serum anti-dsDNA antibodies, levels

of which normalized by the end of the study period. One patient withdrew

from the study because of infusion-related dizziness and headache.

" Our results confirm the importance of tumor necrosis factor-alpha as a

therapeutic target in rheumatoid arthritis and show the feasibility of

combining methotrexate and infliximab to achieve long-term control, " the

investigators conclude. They have begun a 2-year trial where infliximab

is given at 4- or 8-week intervals along with methotrexate.

J Rheumatol 2000;27:841-850. Westport Newsroom 203 319 2700

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