Rheumatoid Arthritis Patients Could Benefit From Reduction of Prescriptions

For some patients diagnosed with rheumatoid arthritis, a full dose of medication may not be needed as the condition progresses.

According to study results published in the New England Journal of Medicine, a group of patients who took 50 mg of the drug etanercept and methotrexate for 52 weeks were able in many cases to reduce their intake. Some patients were given 25 mg of the drug as well as methotrexate at weeks 39 and 52 while others were given just methotrexate and some were given a placebo for 39 weeks. The authors noted that patients who had “qualifying responses at week 39 of the double-blind phase had all treatment withdrawn.” That group was then monitored until the 65^th week of the study during the withdrawal phase.

“The primary end point was the proportion of patients with sustained remission in the double-blind phase,” they noted.

The total group included 306 patients, of which 193 were enrolled in the double-blind phase and 131 reached the levels needed for the withdrawal phase. The authors reported patients in the “combination-therapy group” reached the criterion for the primary end point at a higher rate than the other groups. That group saw 40 of the 63 patients or 63% reach the end point compared to 26 of 65 or 40% in the methotrexate group or just 16 of 65 or 23% in the placebo group (P=0.009 for combination therapy vs. methotrexate alone; P<0.001 for combination therapy vs. placebo.

Remission was reached at 65 weeks by 44% of the members of the combination group (28 patients), 29% of the methotrexate group (19 patients), and 23% in the placebo group (15 patients).

During the course of treatment, the authors noted “no significant between-group differences” in radiographic images of the disease. They also reported “serious adverse events” in 3 patients in the combination therapy group, 2 patients in the methotrexate group and 2 in the placebo group.

Overall, the authors said they were pleased with the results of the study.

“In patients with early rheumatoid arthritis who had a remission while receiving full-dose etanercept-plus-methotrexate therapy, continuing combination therapy at a reduced dose resulted in better disease control than switching to methotrexate alone or placebo, but no significant difference was observed in radiographic progression.”