RA clinical remission possible with half etanercept dose

Maintaining clinical remission with half-dose etanercept is possible for many rheumatoid arthritis patients, according to a single-center, prospective cohort study.

Over 80% of rheumatoid arthritis (RA) patients in remission who were randomized to a half dose treatment of 25 mg of etanercept per week were still in remission after an average follow-up period of 3.6 years, Dr. Bernd Raffeiner and his colleagues at the University of Padova (Italy) reported (Clin. Exp. Rheumatol. 2014 Dec. 22).

The study randomized 323 RA patients to etanercept 25 mg weekly (group A, n = 159) or etanercept 25 mg bi-weekly (group B, n = 164). The patients had a mean age of 56 years and about 82% were female. had failed traditional synthetic disease-modifying antirheumatic drugs and then achieved remission on etanercept 25 mg bi-weekly (50 mg per week). The investigators defined remission as a 28-joint disease activity score using erythrocyte sedimentation rate of less than 2.6 for at least 12 months.

At the end of follow-up, 81.8% of the patients in group A maintained remission for a mean of 3.6 years.

These patients were slightly younger than those who failed dose reduction and were taking fewer nonsteroidal anti-inflammatory drugs. Disease activity prior to biologic therapy did not influence response to half-dose etanercept.

The data showed that half-dose etanercept halted radiographic damage as effectively as standard dose, the researchers said. About 80% of patients reached radiographic remission, and almost 20% showed minor radiographic changes. Just 1.5% of patients experienced a relevant progression among all groups.

Patients who flared during dose reduction and returned to full dose did not show a greater radiographic progression.

“Low dose etanercept seems to prevent radiographic damage even if full clinical response is not achieved,” they wrote.

Furthermore, most (75.9%) of the patients who went back onto full-dose treatment regained remission.

Etanercept has unique pharmacokinetics and pharmacodynamics that are different from other TNF-α inhibitors, which could make it more suitable for dose adjustment, the study authors suggested.

The findings have important economic implications, they said. In Italy, low-dose etanercept is the lowest priced biologic treatment protocol available that meets the present standards in RA therapy.

“The resources gained could be invested for candidate patients for TNF-α inhibitor or other biologic therapy, especially in situations where policy maker intervention sets limitations to contain ever more increasing healthcare costs,” they wrote.

There were no conflicts of interest declared.

Maintaining clinical remission with half-dose etanercept is possible for many rheumatoid arthritis patients, according to a single-center, prospective cohort study.

Over 80% of rheumatoid arthritis (RA) patients in remission who were randomized to a half dose treatment of 25 mg of etanercept per week were still in remission after an average follow-up period of 3.6 years, Dr. Bernd Raffeiner and his colleagues at the University of Padova (Italy) reported (Clin. Exp. Rheumatol. 2014 Dec. 22).

The study randomized 323 RA patients to etanercept 25 mg weekly (group A, n = 159) or etanercept 25 mg bi-weekly (group B, n = 164). The patients had a mean age of 56 years and about 82% were female. had failed traditional synthetic disease-modifying antirheumatic drugs and then achieved remission on etanercept 25 mg bi-weekly (50 mg per week). The investigators defined remission as a 28-joint disease activity score using erythrocyte sedimentation rate of less than 2.6 for at least 12 months.

At the end of follow-up, 81.8% of the patients in group A maintained remission for a mean of 3.6 years.

These patients were slightly younger than those who failed dose reduction and were taking fewer nonsteroidal anti-inflammatory drugs. Disease activity prior to biologic therapy did not influence response to half-dose etanercept.

The data showed that half-dose etanercept halted radiographic damage as effectively as standard dose, the researchers said. About 80% of patients reached radiographic remission, and almost 20% showed minor radiographic changes. Just 1.5% of patients experienced a relevant progression among all groups.

Patients who flared during dose reduction and returned to full dose did not show a greater radiographic progression.

“Low dose etanercept seems to prevent radiographic damage even if full clinical response is not achieved,” they wrote.

Furthermore, most (75.9%) of the patients who went back onto full-dose treatment regained remission.

Etanercept has unique pharmacokinetics and pharmacodynamics that are different from other TNF-α inhibitors, which could make it more suitable for dose adjustment, the study authors suggested.

The findings have important economic implications, they said. In Italy, low-dose etanercept is the lowest priced biologic treatment protocol available that meets the present standards in RA therapy.

“The resources gained could be invested for candidate patients for TNF-α inhibitor or other biologic therapy, especially in situations where policy maker intervention sets limitations to contain ever more increasing healthcare costs,” they wrote.

There were no conflicts of interest declared.

Maintaining clinical remission with half-dose etanercept is possible for many rheumatoid arthritis patients, according to a single-center, prospective cohort study.

Over 80% of rheumatoid arthritis (RA) patients in remission who were randomized to a half dose treatment of 25 mg of etanercept per week were still in remission after an average follow-up period of 3.6 years, Dr. Bernd Raffeiner and his colleagues at the University of Padova (Italy) reported (Clin. Exp. Rheumatol. 2014 Dec. 22).

The study randomized 323 RA patients to etanercept 25 mg weekly (group A, n = 159) or etanercept 25 mg bi-weekly (group B, n = 164). The patients had a mean age of 56 years and about 82% were female. had failed traditional synthetic disease-modifying antirheumatic drugs and then achieved remission on etanercept 25 mg bi-weekly (50 mg per week). The investigators defined remission as a 28-joint disease activity score using erythrocyte sedimentation rate of less than 2.6 for at least 12 months.

At the end of follow-up, 81.8% of the patients in group A maintained remission for a mean of 3.6 years.

These patients were slightly younger than those who failed dose reduction and were taking fewer nonsteroidal anti-inflammatory drugs. Disease activity prior to biologic therapy did not influence response to half-dose etanercept.

The data showed that half-dose etanercept halted radiographic damage as effectively as standard dose, the researchers said. About 80% of patients reached radiographic remission, and almost 20% showed minor radiographic changes. Just 1.5% of patients experienced a relevant progression among all groups.

Patients who flared during dose reduction and returned to full dose did not show a greater radiographic progression.

“Low dose etanercept seems to prevent radiographic damage even if full clinical response is not achieved,” they wrote.

Furthermore, most (75.9%) of the patients who went back onto full-dose treatment regained remission.

Etanercept has unique pharmacokinetics and pharmacodynamics that are different from other TNF-α inhibitors, which could make it more suitable for dose adjustment, the study authors suggested.

The findings have important economic implications, they said. In Italy, low-dose etanercept is the lowest priced biologic treatment protocol available that meets the present standards in RA therapy.

“The resources gained could be invested for candidate patients for TNF-α inhibitor or other biologic therapy, especially in situations where policy maker intervention sets limitations to contain ever more increasing healthcare costs,” they wrote.

There were no conflicts of interest declared.