Patients with moderate-to-severe early rheumatoid arthritis (RA) achieved three measures of remission—radiographic, functional, and clinical—with ETN plus MTX, according to 1-year results from Combination of Methotrexate and Etanercept in Active Early Rheumatoid Arthritis (COMET) study presented at the annual European League Against Rheumatism meeting in Paris, France.1
"These results demonstrate that remission is a realistic therapeutic goal when combination therapy is initiated early in the RA disease process," concluded lead study author Paul Emery, MD, a professor of rheumatology at the University of Leeds in the United Kingdom.
Fully 80% of patients with early active RA achieved radiographic remission (or nonprogression defined as a change in total sharp score of ≤0.5 at 1 year) when treated with ETN plus MTX. By contrast, 59% of patients achieved radiographic remission when treated with MTX alone.
In the COMET study, half of patients who took the combination regimen achieved clinical remission defined as a disease activity score 28 of <2.6, and nearly 55% achieved functional remission defined as a health assessment questionnaire score of <0.5. These results compare with 28% and 39% of patients, respectively, when treated with MTX alone.
"These exciting results lead to the next therapeutic step in aiming for multiple measures of remission as our treatment goal, no longer just one," Dr. Emery said in a press release. "Given that these levels of remission have not previously been seen and represent the optimal goal, these results will lead to the need for treatment of RA with an anti-TNF treatment option such as ETN at the earliest appropriate opportunity to halt disease progression."
There were no differences in rates of serious infections or malignancies among patients in the ETN plus MTX group compared with the MTX monotherapy group.
Reference
1. Emery P, Breedveld F, Hall S, et al. Clinical remission, radiographic non-progression and normalized function with the combination of etanercept and methotrexate in the treatment of early active rheumatoid arthritis: 1-year results of the COMET trial. Presented at: EULAR 2008; June 11-14, 2008; Paris, France. Abstract OP-0008.
Lynn - I'm early RA (less than 2 yrs) and my one year anniversay for mtx/enbrel combo is in August. I had no erosion/damage on xrays when diagnosed and while I haven't had xrays since, I'm assuming that since my inflammation has been kept pretty well controlled that it hasn't changed much. I'm assuming my activity score is good as well, but not sure what makes up the measurement for disease activity. I suppose I could goggle it, but thought I'd ask. When they say clinical remission is defined as a disease activity score 28 of <2.6 - what does that mean?