Sustained improvements in MRI outcomes with abatacept following the withdrawal of all treatments in patients with early, progressive rheumatoid arthritis.
Ann Rheum Dis
; 75(8): 1501-5, 2016 Aug.
Article
em En
| MEDLINE
| ID: mdl-26865601
ABSTRACT
OBJECTIVES:
To assess structural damage progression with subcutaneous abatacept (ABA) in the Assessing Very Early Rheumatoid arthritis Treatment (AVERT) trial following abrupt withdrawal of all rheumatoid arthritis (RA) medication in patients achieving Disease Activity Score (DAS)-defined remission or low disease activity.METHODS:
Patients with early, active RA were randomised to ABA plus methotrexate (ABA/MTX) 125â mg/week, ABA 125â mg/week or MTX for 12â months. All RA treatments were withdrawn after 12â months in patients with DAS28 (C reactive protein (CRP)) <3.2. Adjusted mean changes from baseline in MRI-based synovitis, osteitis and erosion were calculated for the intention-to-treat population.RESULTS:
351 patients were randomised and treated ABA/MTX (n=119), ABA (n=116) or MTX (n=116). Synovitis and osteitis improved, and progression of erosion was statistically less with ABA/MTX versus MTX at month 12 (-2.35 vs -0.68, -2.58 vs -0.68, 0.19 vs 1.53, respectively; p<0.01 for each) and month 18 (-1.34 vs -0.49 -2.03 vs 0.34, 0.13 vs 2.0, respectively; p<0.01 for erosion); ABA benefits were numerically intermediate to those for ABA/MTX and MTX.CONCLUSIONS:
Structural benefits with ABA/MTX or ABA may be maintained 6â months after withdrawal of all treatments in patients who have achieved remission or low disease activity. TRIAL REGISTRATION NUMBER NCT01142726; Results.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Antirreumáticos
/
Abatacepte
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article