Rheumatology Medical News about early rheumatoid arthritis;radiographic progression;Adalimumab plus Methotrexate;Methotrexate monotherapy

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Less radiographic progression with adalimumab plus methotrexate versus methotrexate monotherapy across the spectrum of clinical response in early rheumatoid arthritis
Journal of Rheumatology, 07/02/09

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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