Rheumatoid arthritis remission doubled if patients given combination treatment

The chance of remission from rheumatoid arthritis (RA) is almost doubled if patients are given a combination of methotrexate and etanercept, rather than methotrexate alone, claims an international team of experts.

Findings from a study of over 500 patients with active, early, moderate-to-severe RA showed that 50 per cent of those given the combination achieved clinical remission, compared with just 28 per cent of those given methotrexate alone.

‘The positive clinical outcomes of the treatment also seem to determine the ability of patients to remain in employment,’ write the study authors in an early online issue of the Lancet.

One in four of those given methotrexate had stopped work for a period in the previous year, compared with one in 10 in the combination group.

For the COMET study, patients were randomly assigned to a combination or methotrexate-alone group. In both arms of the trial, methotrexate dosage was raised from 7.5 mg weekly to a maximum of 20 mg weekly and those in the combination arm also received 50 mg etanercept weekly.

At one-year follow-up, as well as clinical remission, improvements in radiographic non-progression were seen in the combination group. Radiographic non-progression was noted in 80 per cent of those in the combination group, but just 59 per cent of those given methotrexate alone.

‘Furthermore, these outcomes appear to be achieved without exposing patients to significant additional risk,’ say the researchers, led by Professor Paul Emery at the University of Leeds.

rachel.liddle@haymarket.com

www.thelancet.com

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