Infliximab in active early rheumatoid arthritis

被引:170
作者
Breedveld, FC
Emery, P
Keystone, E
Patel, K
Furst, DE
Kalden, JR
St Clair, EW
Weisman, M
Smolen, J
Lipsky, PE
Maini, RN
机构
[1] Leiden Univ, Dept Rheumatol, NL-2300 RC Leiden, Netherlands
[2] Univ Leeds, Dept Rheumatol, Acad Unit Musculoskeletal Dis, Leeds, W Yorkshire, England
[3] Univ Toronto, Toronto, ON, Canada
[4] Centocor Inc, Malvern, PA 19355 USA
[5] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA
[6] Univ Erlangen Nurnberg, Dept Internal Med 3, D-8520 Erlangen, Germany
[7] Univ Erlangen Nurnberg, Inst Clin Immunol, D-8520 Erlangen, Germany
[8] Duke Univ, Med Ctr, Div Rheumatol & Immunol, Durham, NC USA
[9] Univ Vienna, Dept Rheumatol, Vienna, Austria
[10] Lainz Hosp, Dept Med 2, Vienna, Austria
[11] NIAMSD, Intramural Res Program, Bethesda, MD 20892 USA
[12] Kennedy Inst, London, England
[13] Imperial Coll Sch Med, London, England
关键词
D O I
10.1136/ard.2003.013961
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To examine the impact of the combination of infliximab plus methotrexate (MTX) on the progression of structural damage in patients with early rheumatoid arthritis (RA). Methods: Subanalyses were carried out on data for patients with early RA in the Anti-TNF Therapy in RA with Concomitant Therapy (ATTRACT) study, in which 428 patients with active RA despite MTX therapy received placebo with MTX (MTX-only) or infliximab 3 mg/kg or 10 mg/kg every (q) 4 or 8 weeks with MTX ( infliximab plus MTX) for 102 weeks. Early RA was defined as disease duration of 3 years or less; 82 of the 428 patients (19%) met this definition. Structural damage was assessed with the modified van der Heijde-Sharp score. The changes from baseline to week 102 in total modified van der Heijde-Sharp score were compared between the infliximab plus MTX groups and the MTX-only group. <LF>Results: The erosion and joint space narrowing scores from baseline to week 102 in the cohort of patients with early RA decreased significantly in each infliximab dose regimen compared with the MTX-only regimen. Consistent benefit was seen in the joints of both hands and feet. Conclusions: Infliximab combined with MTX inhibited the progression of structural damage in patients with early RA during the 2 year period of treatment. Early intervention with infliximab in patients with active RA despite MTX therapy may provide long term benefits by preventing radiographic progression and preserving joint integrity.
引用
收藏
页码:149 / 155
页数:7
相关论文
共 41 条
[1]   The rheumatoid arthritis patient in the clinic: comparing more than 1300 consecutive DMARD courses [J].
Aletaha, D ;
Smolen, JS .
RHEUMATOLOGY, 2002, 41 (12) :1367-1374
[2]   Practical progress in realisation of early diagnosis and treatment of patients with suspected rheumatoid arthritis: results from two matched questionnaires within three years [J].
Aletaha, D ;
Eberl, G ;
Nell, VPK ;
Machold, KP ;
Smolen, JS .
ANNALS OF THE RHEUMATIC DISEASES, 2002, 61 (07) :630-634
[3]  
Anderson JJ, 2000, ARTHRITIS RHEUM, V43, P22, DOI 10.1002/1529-0131(200001)43:1<22::AID-ANR4>3.0.CO
[4]  
2-9
[5]   Subgroup analysis and other (mis)uses of baseline data in clinical trials [J].
Assmann, SF ;
Pocock, SJ ;
Enos, LE ;
Kasten, LE .
LANCET, 2000, 355 (9209) :1064-1069
[6]   Prospective two year follow up study comparing novel and conventional imaging procedures in patients with arthritic finger joints [J].
Backhaus, M ;
Burmester, GR ;
Sandrock, D ;
Loreck, D ;
Hess, D ;
Scholz, A ;
Blind, S ;
Hamm, B ;
Bollow, M .
ANNALS OF THE RHEUMATIC DISEASES, 2002, 61 (10) :895-904
[7]   A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis [J].
Bathon, JM ;
Martin, RW ;
Fleischmann, RM ;
Tesser, JR ;
Schiff, MH ;
Keystone, EC ;
Genovese, MC ;
Wasko, MC ;
Moreland, LW ;
Weaver, AL ;
Markenson, J ;
Finck, BK .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (22) :1586-1593
[8]   Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis [J].
Boers, M ;
Verhoeven, AC ;
Markusse, HM ;
vandeLaar, MAFJ ;
Westhovens, R ;
vanDenderen, JC ;
vanZeben, D ;
Dijkmans, BAC ;
Peeters, AJ ;
Jacobs, P ;
vandenBrink, HR ;
Schouten, HJA ;
vanderHeijde, DMFM ;
Boonen, A ;
vanderLinden, S .
LANCET, 1997, 350 (9074) :309-318
[9]  
Bombardier C, 2002, ARTHRITIS RHEUM-US, V46, pS344
[10]  
Bukhari MAS, 2001, ARTHRITIS RHEUM, V44, pS153