Younger, thinner rheumatoid arthritis patients, with lower disease activity and better scores on a certain health assessment, have a better chance of achieving remission when combining the tumor-necrosis factor (TNF) inhibitor etanercept (enbrel) with methotrexate induction therapy.
“These findings may help guide clinicians’ decision-making as they treat patients to remission and beyond,” write Josef Smolen, of Austria’s Medical University of Vienna, and colleagues writing in Arthritis Research & Therapy.
The study is a post-hoc analysis of the 2013 PRESERVE trial, which began with 834 patients, ages 18 to 70, whose moderate rheumatoid arthritis persisted following methotrexate treatment. All of the patients had received weekly doses of 15 to 25 mg of methotrexate for a minimum of eight weeks, and for 36 weeks, all received 50 mg of etanercept and methotrexate weekly.
Of those enrolled, 604 were eligible for a double-blind period, where one group received 50 mg of etanercept as well as methotrexate; a second received 25 mg of etanercept as well as methotrexate; and the third received placebo and methotrexate.
“Conventional or reduced doses of etanercept with methotrexate in patients with moderately active rheumatoid arthritis more effectively maintain low disease activity than does methotrexate alone after withdrawal of etanercept,” the PRESERVE trial found.
The new post-hoc analysis sought to clarify which factors impacted the degree to which remission was achieved and maintained. And, notes MedPage, American College of Rheumatology and European League Against Rheumatism remission criteria have tightened since PRESERVE was conducted.