Less radiographic progression with adalimumab plus methotrexate versus methotrexate monotherapy across the spectrum of clinical response in early rheumatoid arthritis
Emery P et al. – Study demonstrates that adalimumab plus methotrexate (MTX) therapy resulted in less radiographic progression than MTX monotherapy across the spectrum of clinical response in pts with early rheumatoid arthritis (RA). Methods- Aim was to determine the relationship between radiographic progression and clinical response for adalimumab plus MTX vs either monotherapy in RA pts
- Pts with early RA who received adalimumab plus MTX (n=240), adalimumab (n=222), or MTX (n=216) were grouped by:
- American College of Rheumatology (ACR) response
- 28-joint Disease Activity Score (DAS28), or
- Remission-like state
- at 26 and 104 wks
- Radiographic progression was assessed by cumulative probability plots, mean changes in total Sharp score (ΔTSS), and percentages of progressors (ΔTSS >0.5)
Results- Therapy with adalimumab plus MTX permitted less radiographic progression at wks 26 and 104 than MTX monotherapy
- Adalimumab monotherapy was generally intermediate
- A strong, proportional relationship was observed between clinical response and radiographic efficacy only for MTX monotherapy
- Monotherapies approximated the radiographic efficacy of adalimumab plus MTX only among remission-like responders
- Although progression was greater with MTX monotherapy vs adalimumab plus MTX for pts with TJC=0
- Concurrent clinical and radiographic remission was more frequent at wk 104 with adalimumab plus MTX vs adalimumab or MTX monotherapy
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