Some RA Patients May Qualify for Adalimumab Break

Article

More than three-fourths of long-term rheumatoid arthritis patients are able to stop taking adalimumab if they achieve deep remission, according to a Japanese study.

Tanaka Y, Hirata S, Kubo S, et al., Discontinuation of adalimumab after achieving remission in patients with established rheumatoid arthritis: 1-year outcome of the HONOR study. Ann Rheum Dis. 2013 Nov 28. doi: 10.1136/annrheumdis-2013-204016. [Epub ahead of print] Free full text.


A drug “holiday” is possible for established rheumatoid arthritis (RA) patients who stay in deep remission for a year after discontinuing adalimumab (Humira), this study from Japan suggests.

In the open-label, non-randomized study, 197 patients with active, moderate-to-severe RA (mean age 60.7, mean disease duration 8.9 years) were given subcutaneous injections of 40 mg adalimumab plus methotrexate every other week from July 2008 to April 2011.

A total of 75 patients achieved and maintained remission for at least six months and qualified for a period free from adalimumab. Among those, 52 agreed to discontinue the agent while 23 continued on the drug.

Remission was defined as having a sustained 28-joint disease activity, an erythrocyte sedimentation rate (DAS28-ESR) of less than 2.6, and remaining steroid-free with a stable methotrexate dose.

After one year, approximately 80% of patients judged to be in deep remission were able to sustain low disease activity compared to 42% of those with mild remission, leading the to researchers suggest that mild remission “may be insufficient for [adalimumab] discontinuation in established RA.”

The authors point out that re-starting adalimumab effectively returned 90% of patients with flare to DAS28-ESR of less than 3.2 withinsix months.

While equal numbers in the continuation group sustained or failed remission at one year (n=25, n=27, respectively), those able to sustain remission were generally younger, with shorter baseline disease duration, lower DAS28 and ESR values, and shorter adalimumab treatment periods.

 

 

Recent Videos
Signs and Symptoms of Connective Tissue Disease
Connective Tissue Disease Brings Dermatology & Rheumatology Together
© 2024 MJH Life Sciences

All rights reserved.