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Addition of another disease-modifying anti-rheumatic drug to methotrexate reduces the flare rate within 2 years after infliximab discontinuation in patients with rheumatoid arthritis: an open, randomized, controlled trial.
- Source :
-
Modern rheumatology [Mod Rheumatol] 2014 Jul; Vol. 24 (4), pp. 561-6. Date of Electronic Publication: 2013 Nov 05. - Publication Year :
- 2014
-
Abstract
- Objectives: We examined whether the addition of another conventional disease-modifying anti-rheumatic drugs (DMARDs) to methotrexate (MTX) upon infliximab (IFX) discontinuation in well-controlled rheumatoid arthritis (RA) patients could suppress subsequent disease flare.<br />Methods: RA patients maintaining DAS28-CRP (Disease Activity Score of 28 joints with C-reactive protein) scores < 2.6 for ≥ 6 months with IFX were randomized either to receive addition of bucillamine (BUC) to MTX (BUC + MTX group; n = 24) or not (MTX group; n = 31) upon discontinuing IFX. The primary endpoint was the flare rate within 2 years of IFX discontinuation.<br />Results: Six patients discontinuing MTX during the study were excluded from analyses. Seventeen patients (63.0%) experienced flares in the MTX group, which was significantly reduced in the BUC + MTX group (31.8%; p = 0.045). Further, the flare rates differed significantly between remission and non-remission by a Boolean definition upon IFX discontinuation in the MTX group (40.0% vs. 91.7%, respectively; p = 0.014), but they were comparable in the BUC + MTX group. BUC treatment was interrupted in seven patients due to rash, proteinuria and incompliance.<br />Conclusions: DMARDs combination therapy may be a better treatment strategy than MTX monotherapy for maintaining RA control after successful discontinuation of biological agents.
- Subjects :
- Adult
Aged
Cysteine therapeutic use
Disease Progression
Drug Therapy, Combination
Female
Humans
Infliximab
Male
Middle Aged
Treatment Outcome
Young Adult
Antibodies, Monoclonal therapeutic use
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid drug therapy
Cysteine analogs & derivatives
Methotrexate therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1439-7609
- Volume :
- 24
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Modern rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 24252035
- Full Text :
- https://doi.org/10.3109/14397595.2013.844886