RESEARCH - Kineret (anakinra) plus a DMARD improves function in RA

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Anakinra Plus a DMARD Improves Function in Rheumatoid Arthritis

NEW YORK (Reuters Health) Sept 25 - The addition of anakinra to

treatment with a traditional disease-modifying antirheumatic drug

(DMARD) safely improves functional status in patients with active

rheumatoid arthritis, according to research conducted in Europe.

In previous trials of the interleukin-1 receptor antagonist, anakinra

proved safe and effective in reducing disease activity and

radiographic progression in patients with rheumatoid arthritis.

For the current report in the August issue of the Journal of

Rheumatology, Dr. Xavier Le Loet, at Rouen University Hospital in

France, and colleagues analyzed changes in functional status in the

Outcome Measures Generated by Anakinra (OMEGA) trial.

The open-label, single-arm trial included 1207 patients who had been

treated with a stable dose of methotrexate, sulfasalazine or

hydroxychloroquine for at least 3 months. Upon enrollment, patients

started treatment with anakinra (100 mg daily as a subcutaneous

injection) while continuing with a single DMARD for up to 36 weeks.

The overall mean percentage improvements were 13% in Health Assessment

Questionnaire disability index scores and 25% for 28-joint Disease

Activity Score. " Meaningful changes " were observed for dressing,

grooming, eating, and the ability to reach and grip, with no

significant differences associated with specific DMARDs.

" Further, " the authors report, " 64.0% of patients received a good or

moderate European League Against Rheumatism (EULAR) response score at

week 36. "

Other than injection site reactions, reported by 62% of patients, the

most frequent treatment-related adverse events were erythema (4.2%),

pruritus (3.9%), headache (2.6%), and nausea (1.3%).

One patient developed lymphoma and there was one case of pulmonary

tuberculosis. According to the authors, " to date, this is the only

case of tuberculosis infection reported in clinical trials in

rheumatoid arthritis with anakinra. "

" Our study results support the use of anakinra as a treatment option, "

Dr. Le Loet and colleagues maintain, " especially when combinations of

traditional DMARD or tumor necrosis factor antagonists are not

suitable for a given patient. "

J Rheumatol 2008;35:1538-1544.

http://www.medscape.com/viewarticle/581089

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