RESEARCH - Benefits 8 years after a remission induction regime of Remicade plus MTX in early RA

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Rheumatology (Oxford). 2010 Oct;49(10):1971-4. Epub 2010 Jul 1.

Benefits 8 years after a remission induction regime with an infliximab

and methotrexate combination in early rheumatoid arthritis.

Bejarano V, Conaghan PG, Quinn MA, Saleem B, Emery P.

Academic Section of Musculoskeletal Disease, Leeds Institute of

Molecular Medicine, University of Leeds Leeds, UK.

Abstract

OBJECTIVE: To ascertain whether a 1-year remission induction therapy

with an infliximab-MTX (INF-MTX) combination in patients with early RA

provided sustained benefit after INF cessation compared with

conventional treatment.

METHODS: Twenty patients with poor prognosis RA of < 1 year of disease

duration were randomized to receive either INF and MTX or placebo

infusions and MTX for 1 year. They then stepped down to MTX

monotherapy and were treated according to standard clinical care.

After 8 years, disease activity, function and quality of life (QoL)

data were collected.

RESULTS: At follow-up, data were available for 18 patients (1 in each

group had died). Median 28-joint DAS was significantly lower in the

INF-MTX group compared with placebo-MTX group (2.7 vs 4.3, P = 0.02).

Four patients in the INF-MTX group were in remission vs none in the

placebo-MTX group. One patient in the INF-MTX group achieved drug-free

remission. Both RAQoL and HAQ median scores were lower in the INF-MTX

group; however, this did not reach statistical significance (median

RAQoL 3 vs 8, P = 0.18; median HAQ 1.0 vs 1.5, P = 0.12).

CONCLUSION: A remission induction regime with an INF-MTX combination

for 1 year in early RA can improve long-term clinical outcomes. Larger

studies will be required to confirm the implications of these

findings.

PMID: 20595536

http://www.ncbi.nlm.nih.gov/pubmed/20595536

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