NEW YORK (Reuters Health) Oct 09 - In patients with rheumatoid arthritis (RA), treatment with adalimumab, a monoclonal antibody against tumor necrosis factor, leads to minimal erosive progression, but healing of established erosion is rare, according to Danish researchers.
In the September issue of the Annals of the Rheumatic Diseases, Dr. U. Moller Dohn of Copenhagen University, Hvidovre, and colleagues report that they used high-resolution CT and radiography to track changes in 52 patients who were naive to biological agents and were receiving methotrexate treatment.
The subjects, who had at least two low-grade radiographic erosions in the wrist or metacarpophalangeal joints in the same hand, initiated adalimumab 40 mg subcutaneously every other week.
Two blinded investigators evaluated CT scans and radiographs obtained at baseline and at 6 and 12 months in 35 patients who completed the study.
At baseline, 483 (60%) of the bones assessed on CT had erosions and 385 (25%) of the assessed sites on radiographs had erosions.
At both 6 and 12 months, there was a significant reduction in disease activity score, C-reactive protein, tender and swollen joints count and Health Assessment Questionnaire score.
No significant change in any imaging parameters of joint destruction was seen over the study period. Results for both CT and radiography were comparable.
At 12 months, 1.6% of the total number of bones assessed by CT showed a decreased erosion score, as did 1.8% of the total sites assessed by radiography. An increase in erosion score was seen in 2.2% of bones on CT and in 1.9% sites on radiography.
"The very limited mean overall progression of bone erosions," the investigators conclude, "supports the view that erosive progression is minimal in patients with RA treated with adalimumab( Humira) in combination with methotrexate."
Ann Rheum Dis 2009;68:1585-1590.
This is of comfort to know as it is the treatment plan that I am on.