RESEARCH - ACR: Short-term biologics early in RA may have longer-term benefits

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ACR: Short-Term Biologics Early in Rheumatoid Arthritis May Have

Longer-Term Benefits

By Crystal Phend, Staff Writer, MedPage Today

Published: October 30, 2008

Reviewed by Zalman S. Agus, MD; Emeritus Professor

University of Pennsylvania School of Medicine.

SAN FRANCISCO, Oct. 30 -- Incorporating biologics into treatment early

in the course of rheumatoid arthritis may keep symptoms at bay for

years or even indefinitely, researchers found.

The addition of etanercept (Enbrel) to methotrexate for newly

symptomatic patients doubled the remission rate a year later even when

etanercept was discontinued (P<0.05), Sheehy, M.B., of Connolly

Hospital in Dublin, Ireland, and colleagues reported at the American

College of Rheumatology meeting here.

Follow-up of some patients beyond the small 48-week randomized trial

showed sustained remission three years after etanercept withdrawal,

which Dr. Sheehy said her group hopes would continue indefinitely.

These findings supported the idea of a window of opportunity early in

rheumatoid arthritis when the burden of disease is lower and the

potential of remission is greater, Dr. Sheehy said.

Biologics may not be the only way to take advantage of this window, she said.

" However you can, get the inflammation down, " Dr. Sheehy said. " But

the biologics seem to work more quickly. "

Treatment with tumor necrosis factor (TNF) inhibitors for established

rheumatoid arthritis is given indefinitely because most patients have

flares when the drug is stopped, she said.

But long-term use of these expensive drugs has raised concerns about

infection and malignancy, although another study presented at the

meeting suggested cancer fears were unfounded. (See: ACR: No Cancer

Risk with TNF-Inhibitors for Rheumatoid Arthritis) .

Several trials have explored early treatment with biologics, but the

only two to try withdrawal after remission used infliximab (Remicade).

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Read the entire article here:

http://www.medpagetoday.com/MeetingCoverage/ACR/11554

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