Paris, France, Wednesday June 11th 2008: At least 50% of recent onset rheumatoid arthritis patients achieve remission (a state free of signs and symptoms) within 36 weeks when following a systematic approach of step-up DMARD treatment in combination with tight control, according to results of a study presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France. Results of this study indicate that achieving remission is not only possible during clinical trials but can be a realistic goal of standard clinical care.
Of 169 early RA patients, remission (defined as DAS28<2.6) was achieved in 15.5% at week 8 (23/148), 22.2% at week 12 (24/108), 30.7% at week 20 (23/75), 38.8% at week 24 (33/85), 52.1% at week 36 (38/73) and 51% at week 48-52 (26/51).
The researchers achieved these results through implementation of a tightly regulated DMARD treatment scheme, as follows:
- Methotrexate 15mg/week was initiated following diagnosis
- If remission was not achieved at week 8, the dose was increased to 25mg/week
- If not achieved at week 12, sulfasalazine was added (2grams/day)
- If not achieved at week 20, the dose was increased to 3grams/day
- If not achieved at week 24 adalimumab was added to methotrexate
- Every 3 months thereafter, therapy could be adjusted based on DAS28, also using other TNF-blockers. Patients were allowed to take NSAIDs, and prednisolone ≤10mg/day and intra-articular corticosteroid injections could be administered
Dr. H. Kuper and Prof M. van de Laar of Medisch Spectrum Twente & University Twente, the Netherlands, who led the study, said; "In many large clinical trials, remission can be considered a realistic goal. We set out to determine whether all patients presenting in daily clinical practice can reasonably expect to achieve a state free of signs and symptoms, if a strict treatment schedule was
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