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Effects of half dose etanercept (25 mg once a week) on clinical remission and radiographic progression in patients with rheumatoid arthritis in clinical remission achieved with standard dose

1, 2, 3, 4, 5, 6, 7, 8

 

  1. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  2. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  3. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  4. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  5. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  6. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  7. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  8. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.

CER7567
2015 Vol.33, N°1
PI 0063, PF 0068
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PMID: 25535985 [PubMed]

Received: 03/05/2014
Accepted : 29/07/2014
In Press: 22/12/2014
Published: 04/03/2015

Abstract

OBJECTIVES:
This prospective long-term follow-up study evaluated the effects of half-dose etanercept (25 mg weekly) on clinical remission and radiographic progression in a large cohort of patients with rheumatoid arthritis (RA) in clinical remission after etanercept 25 mg bi-weekly.
METHODS:
524 biologic-naïve RA patients were treated with etanercept 25 mg bi-weekly after failure of conventional drugs. Patients achieving remission (DAS28 <2.6) for ≥12 months were randomised to receive etanercept 25 mg weekly or 25 mg bi-weekly. Patients were assessed at baseline and every 12 weeks. Remission rates, radiographic progression, incidence of infections and costs of the regimens were compared.
RESULTS:
After a mean follow-up of 18±11 months, 347 patients (66.2%) achieved DAS28 remission; 323 were randomised to one of two dose regimens: etanercept 25 weekly (group A, 159 patients) and etanercept 25 mg bi-weekly (group B, 164 patients). At the end of follow-up, 81.8% patients of group A maintained remission for a mean of 3.6±1.5 years. Radiographic progression occurred in a small number of patients of group A and the rate of radiographic progression (TSS >0) was not significantly different in the two groups (18.85% vs. 19.0% after the first year and 16.9% vs. 21.6% after the second year, respectively). The incidence ratio of severe infections was 2.3/1.000 patient-years in group A. Etanercept half-dose regimen resulted in a saving of €3.190.545 with a cost saving up to €827.318 per year.
CONCLUSIONS:
Clinical remission and arrest of radiographic progression persisted in a substantial percentage of patients with RA even after reduction of standard-dose etanercept.

Rheumatology Article