RESEARCH - When RA is early but prognosis is poor, Orencia and MTX are helpful

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When RA Is Early but Prognosis Is Poor, Abatacept and Methotrexate Are Helpful

NEW YORK (Reuters Health) Dec 07 - Prompt use of abatacept plus

methotrexate is advisable for rheumatoid arthritis (RA) patients with

early disease but poor prognostic factors, such as erosions and

rheumatoid antibodies, researchers report in the December issue of the

Archives of the Rheumatic Diseases.

As lead investigator Dr. Rene Westhovens told Reuters Health,

" Sustained disease remission is an achievable goal for many patients

with early RA -- even with poor prognostic factors -- when treatment

with a combination of abatacept and methotrexate is initiated early. "

Dr. Westhovens of UZ Gasthuisberg, Leuven, Belgium, and colleagues

base their advice on a study of 509 patients with RA for 2 years or

less. All were methotrexate naive and most were seropositive for

rheumatoid factor or anticyclic citrullinated protein type 2 (or both)

and had x-ray evidence of joint erosion.

At baseline, the mean Genant-modified Sharp total score (TS) was 7.1.

All patients were treated for 1 year with methotrexate; 256 were

randomized to receive abatacept as well (approximately 10 mg/kg) and

the remaining 253 received placebo.

At 1 year, based on mean disease activity score in 28 joints and

C-reactive protein levels, 41.4% of the combination group achieved

remission versus 23.3% of the monotherapy group. Also, the combination

therapy group had significantly less disease progression as measured

on x-rays (mean TS change, 0.63 versus 1.06).

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Read the rest of the article here:

http://www.medscape.com/viewarticle/713501

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