RESEARCH - Biologic therapy for early RA: the latest evidence

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Curr Opin Rheumatol. 2008 May;20(3):314-9.

Biologic therapy for early rheumatoid arthritis: the latest evidence.

Castro-Rueda H, Kavanaugh A.

Center for Innovative Therapy Division of Rheumatology, Allergy and

Immunology University of California, San Diego, California, US

PURPOSE OF REVIEW: To describe current therapeutic trials with

biologic agents for early rheumatoid arthritis, analyzing clinical and

radiographic outcomes. RECENT FINDINGS: The use of tumor necrosis

factor-alpha inhibitors in combination with disease-modifying

antirheumatic drugs early after the diagnosis of aggressive rheumatoid

arthritis seems to provide increased clinical benefit over

methotrexate or tumor necrosis factor-alpha inhibitors as monotherapy,

with better outcomes in terms of faster and more extensive clinical

improvement. There also seems to be an increased likelihood of

low-disease activity in some cases even after tapering therapy.

Control of radiographic progression appears to be most effective among

early rheumatoid arthritis patients treated with combination tumor

necrosis factor-alpha inhibitors and methotrexate, although

radiographic outcomes are better with tumor necrosis factor-alpha

inhibitor monotherapy than with methotrexate alone. SUMMARY: The

addition of antitumor necrosis factor-alpha agents to traditional

disease-modifying antirheumatic drugs in early rheumatoid arthritis is

a novel strategy which follows the principle of early and aggressive

therapeutic intervention. Results from recent trials show greater

levels of disease control. The impact on long-term safety and

cost-efficacy are factors which will need to be better characterized

over time.

PMID: 18388524

http://www.ncbi.nlm.nih.gov/pubmed/18388524

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