Discontinuation of infliximab and potential predictors of persistent low disease activity in patients with early rheumatoid arthritis and disease activity score-steered therapy: subanalysis of the BeSt study

Broek, Martijn van den; Klarenbeek, Naomi B; Dirven, Linda; Schaardenburg, D. van; Hulsmans, H M J; Kerstens, P.; Huizinga, Tom W J; Dijkmans, Ben A. C.; Allaart, Cornelia F

doi:10.1136/ard.2010.147751

Cited by 108 publications

(91 citation statements)

References 21 publications

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“…In many patients, particularly those with an inadequate response to DMARD therapy, target attainment will require supplemental therapy with a biologic DMARD, such as an anti-TNF agent. Although therapy may be successfully withdrawn in some patients with early RA who achieve an LDA state 21,22 , patients with longstanding RA will likely require longterm therapy. Longterm observations are therefore necessary to fully understand a particular treatment's benefit-risk profile.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Functional, and Radiographic Benefits of Longterm Adalimumab Plus Methotrexate: Final 10-year Data in Longstanding Rheumatoid Arthritis

Keystone

Heijde²,

Kavanaugh³

et al. 2013

J Rheumatol

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Objective.To examine the longterm effectiveness and safety of adalimumab in patients with longstanding rheumatoid arthritis (RA) and an inadequate response to methotrexate (MTX), and to assess the effect of a 1-year delay in initiation of combination therapy.Methods.DE019 was a 1-year randomized controlled trial (RCT) in which patients received adalimumab 20 mg weekly, adalimumab 40 mg every other week (eow), or placebo; all received concomitant MTX. Patients completing the RCT could receive open-label adalimumab 40 mg eow + MTX for an additional 9 years. Clinical, functional, and radiographic outcomes were assessed using composite measures of disease activity (e.g., American College of Rheumatology responses, 28-joint Disease Activity Score with C-reactive protein, Simplified Disease Activity Index), Health Assessment Questionnaire-Disability Index, and the modified total Sharp score (mTSS), respectively.Results.Of the 619 patients randomized, 457 entered the open-label extension; 202 completed 10 years. At Year 10, patients demonstrated effective disease control and inhibition of radiographic progression. Differences in clinical and functional responses between adalimumab + MTX and placebo + MTX observed during the RCT became less apparent at Year 10. Still, patients who initially received adalimumab + MTX had significantly lower mean ΔmTSS at Year 10 compared with patients who initially received placebo + MTX. No new safety signals arose following up to 10 years of adalimumab + MTX exposure.Conclusion.During up to 10 years of treatment with adalimumab + MTX, patients with longstanding RA experienced effective disease control with no change to the expected safety profile. A 1-year delay in receipt of adalimumab + MTX was associated with reduced effectiveness, suggesting that a window of opportunity to prevent irreversible damage exists even in a population with established RA.

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Section: Discussionmentioning

confidence: 99%

Clinical, Functional, and Radiographic Benefits of Longterm Adalimumab Plus Methotrexate: Final 10-year Data in Longstanding Rheumatoid Arthritis

Keystone

Heijde²,

Kavanaugh³

et al. 2013

J Rheumatol

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“…М. van den Broek и соавт. [26] нашли, что из 104 больных, прекратив-ших лечение ИНФ после достижения ремиссии, 48% во-зобновили эту терапию в связи с обострением РА в среднем только через 17 мес после отмены. Рентгенологического прогрессирования в течение всего времени наблюдения у них не отмечалось.…”

Section: Discussionunclassified

Efficacy of Infliximab in Rheumatoid Arthritis: A Relationship to the Total Dose of the Drug

Аронова¹,

Lukina²,

Сигидин³

2015

rsp

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“…In a post-hoc analysis of the BeSt study (early RA population) [17,18], disease activity and joint damage progression were observed in patients treated with MTX plus infliximab who discontinued infliximab after reaching a low disease activity of DAS ≤ 2.4 for 6 months. There were 104 patients that discontinued infliximab, of whom 77 had received infliximab plus MTX as initial treatment, who were then followed up over a median duration of 7.2 years (range 14-103 months).…”

Section: Failure To Recapture Control and Other Risks In Those Requimentioning

confidence: 99%

Are there dangers in biologic dose reduction strategies?

Chan

Holroyd

Mason

et al. 2016

Autoimmunity Reviews

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Discontinuation of infliximab and potential predictors of persistent low disease activity in patients with early rheumatoid arthritis and disease activity score-steered therapy: subanalysis of the BeSt study

Cited by 108 publications

References 21 publications

Clinical, Functional, and Radiographic Benefits of Longterm Adalimumab Plus Methotrexate: Final 10-year Data in Longstanding Rheumatoid Arthritis

Clinical, Functional, and Radiographic Benefits of Longterm Adalimumab Plus Methotrexate: Final 10-year Data in Longstanding Rheumatoid Arthritis

Efficacy of Infliximab in Rheumatoid Arthritis: A Relationship to the Total Dose of the Drug

Are there dangers in biologic dose reduction strategies?

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