RESEARCH - Effectiveness of anti-TNF therapy in preventing joint damage in RA

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Arthritis Rheum. 2006 Jan;54(1):54-9.

The effectiveness of anti-tumor necrosis factor therapy in preventing

progressive radiographic joint damage in rheumatoid arthritis: A

population-based study.

Finckh A, Simard JF, Duryea J, Liang MH, Huang J, Daneel S, Forster A, Gabay

C, Guerne PA.

Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.

OBJECTIVE: To compare the effectiveness of 3 therapeutic strategies in

preventing progressive joint damage, in a population-based cohort. The 3

strategies were infliximab with concomitant disease-modifying antirheumatic

drugs (DMARDs), etanercept with concomitant DMARDs, and etanercept alone.

METHODS: We used sequential radiographs to assess all patients who were

treated with infliximab or etanercept for >10 months. The rates of erosion

progression and joint space narrowing (JSN) were analyzed using multivariate

regression models for longitudinal data, with adjustment for potential

confounders. RESULTS: A total of 372 patients treated with anti-tumor

necrosis factor (TNF) therapies met the inclusion criteria. The baseline

characteristics of the patients assigned to the 3 strategies were not

significantly different, except that, as expected, more patients were

receiving combination therapy with infliximab. The combination of infliximab

plus DMARDs was significantly more effective than etanercept alone for

controlling erosion progression (P < 0.001), but the effectiveness of the 2

combination-treatment strategies was similar (P = 0.07). The combination of

infliximab plus DMARDs was also more effective at controlling progressive

JSN compared with etanercept alone (P = 0.04) or etanercept plus DMARDs (P =

0.02). Treatment with anti-TNF agents (infliximab or etanercept) plus

concomitant DMARDs was more effective than treatment with etanercept alone

for controlling erosion progression (P = 0.045).

CONCLUSION: When combined with traditional DMARDs, both etanercept and

infliximab appear to offer similar protection against progressive structural

joint damage, and combination therapy with either of these agents appears to

be more effective than treatment with etanercept alone.

PMID: 16385495

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6385495 & dopt=Abstract

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