Efficacy of Enbrel in Refractory RA | Arthritis Information

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AB0210   EFFICACY OF ENANERCEPT IN TREATMENT OF REFRACTORY RHEUMATOID ARTHRITIS

L. LIANG*1, Z. ZHAN1, Y. YE1, D. FU1, H. XU1, X. YANG1
1Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China


Objectives: To evaluate the efficacy and safety of the tumor necrosis factor-α( TNF-α) inhibitor Etanercept in the treatment of patients with refractory rheumatoid arthritis(RRA).
Methods: We retrospectively analyzed 75 cases of RA. In Etanercept treatment group, 40 patients were treated with Enanercept(25mg, twice a week ) combined with weekly oral methotrexate(MTX)(15mg per week) for 12 weeks. 35 patients receiving the same dosage MTX combined with salicylazosulfapyridine(SASP) or leflunomide for 12 weeks were observed as a control group. Clinical assessments used the American College of Rheumatology criteria.
Results: All patients completed treatment. As compared the control group, the Etanercept treatment group had a more rapid improvement in ACR20 and ACR50 in disease activity during the first 6 weeks(37.5% vs 17.1%, 17.5% vs 2.8%, P＜0.01, respectively). At the end of 12 week treatment, the Etanercept treatment group also had siginificant improvement in ACR20 and ACR50 when compared with the control group (65.0% vs 37.1%, 47.5% vs 11.4%, P＜0.01, respectively). Compared with the control group, the Etanercept treatment group had a more obviously decrease of the DAS28 score, and there was aslo siginificant difference between the Etanercept group and the control group after 12 weeks (P<0.05). The most common adverse events of Etanercept included injection site reaction and upper respiratory infection in our study.

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THU0180   ETANERCEPT IMPROVES INFLAMMATION ASSOCIATED ARTERIAL STIFFNESS IN RHEUMATOID ARTHRITIS

B. Galarraga*1, F. Khan1, P. Kumar1, T. Pullar1, J. J. F. Belch1
1Vascular and Inflammatory Diseases Research Unit, University of Dundee, Dundee, United Kingdom

Background: Increased arterial stiffness, an independent risk factor for premature coronary artery disease, has been reported in patients with rheumatoid arthritis (RA).
Objectives: Firstly to assess, in patients with RA, the relationship between disease activity, inflammation and augmentation index, which is a combined measure of arterial stiffness and pulse wave reflection. The second objective was to establish any effect anti-rheumatic treatment may have on augmentation index.
Methods: 148 RA patients with no previous history of cardiovascular disease (CVD) had their augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and parameters of RA disease activity and CV risk measured. 47 patients were then treated with either methotrexate (n=21) or etanercept (n=26) and assessments were repeated at 2 and 4 months.
Results: Patients with high CRP (CRP>10 mg/L) showed significantly higher mean AIx@75 than those with low CRP (CRP≤10 mg/ L) (33±8 % v 30±8 %, p=0.033). On regression analysis Log10CRP (β =0.298, p=0.002), gender (β =0.257, p=0.007), BMI (β =-0.292, p=0.004), diastolic blood pressure (β =0.260, p=0.009) and age (β=0.194, p=0.046) were independently associated with AIx@75.
Treatment with etanercept (35±9 %, 32.5±1 % and 32.5±8 %, p=0.025) but not methotrexate (31±1 %, 31±1 % and 31±1 %, p=0.971) attenuated the AIx@75 significantly from baseline to visit 2 and 3.



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