Combination therapy with methotrexate and the tumor necrosis factor inhibitor etanercept (Enbrel) provided significantly greater clinical and radiographic benefits in early rheumatoid arthritis than treatment with methotrexate alone, an international double-blind study confirmed.
After two years of treatment, 57% of patients receiving the combination had achieved remission, compared with 35% of those on methotrexate alone (P=0.002), according to Paul Emery, MD, of Leeds University in England, and colleagues.
In addition, 90% of patients receiving the combination for two years had no radiographic progression, compared with 67% of those on methotrexate monotherapy (P<0.001), the investigators reported in the March issue of Arthritis & Rheumatism.
Major shifts have taken place in the treatment of rheumatoid arthritis during the past decade, with the widespread use of biologic drugs and increased emphasis on the importance of early treatment.
There also has been a heightened realization that, although treatment with conventional disease-modifying agents such as methotrexate may be effective clinically, radiographic progression and joint destruction can still be occurring.
To evaluate the effects of early combination therapy on both clinical remission and radiographic progression, Emery and colleagues enrolled a large cohort of patients with active rheumatoid arthritis in the COMET (Combination of Methotrexate and Etanercept in Early Rheumatoid Arthritis) trial.
http://www.medpagetoday.com/Rheumatology/Arthritis/18842