Abstract
Objective. To ascertain whether a 1-year remission induction therapy with an infliximab–MTX (INF–MTX) combination in patients with early RA provided sustained benefit after INF cessation compared with conventional treatment.
Methods. Twenty patients with poor prognosis RA of <1 year of disease duration were randomized to receive either INF and MTX or placebo infusions and MTX for 1 year. They then stepped down to MTX monotherapy and were treated according to standard clinical care. After 8 years, disease activity, function and quality of life (QoL) data were collected.
Results. At follow-up, data were available for 18 patients (1 in each group had died). Median 28-joint DAS was significantly lower in the INF–MTX group compared with placebo–MTX group (2.7 vs 4.3, P = 0.02). Four patients in the INF–MTX group were in remission vs none in the placebo–MTX group. One patient in the INF–MTX group achieved drug-free remission. Both RAQoL and HAQ median scores were lower in the INF–MTX group; however, this did not reach statistical significance (median RAQoL 3 vs 8, P = 0.18; median HAQ 1.0 vs 1.5, P = 0.12).
Conclusion. A remission induction regime with an INF–MTX combination for 1 year in early RA can improve long-term clinical outcomes. Larger studies will be required to confirm the implications of these findings.
http://rheumatology.oxfordjournals.org/cgi/content/abstract/keq194Important info to knowBumping