Background/Purpose:

Adalimumab (ADA) showed highly efficacious in rheumatoid arthritis (RA) in the clinical trials, although there is little evidence in daily clinical practice.The clinical usefulness and treatment continuation rate of 52 weeks of a ADA treatment in rheumatoid arthritis (RA) patients were investigated over time.

Methods: The subjects were 124 analyzable patients that had been introduced to ADA treatment at this institution from May 2009 to October 2012. In patients’ background, mean age was 53 years, mean duration of illness 7.2 years, rate of concomitant MTX treatment 96% (116 patients), mean MTX dose 11.4 mg/week, and rate of concomitant PSL treatment 16.1%. Of these patients, 35 had a duration of illness below 2 years (<2 group), 89 a duration of at least 2 years (≥ 2 group), 85 were Bio Naive (N group), 39 were Switch (S group), 95 received MTX ≥10 mg/week(≥10 group), and 24 received MTX<10 mg/week (<10 group). There was no significant difference in baseline disease activity between the groups. Treatment efficacy up to 52 weeks after ADA treatment in each group was investigated comparatively.

Results:

The DAS28 (CRP) remission rate for all the patients at 4, 24, and 52 weeks was 36%,62%,and 70%, respectively, showing that from 4 weeks, about 40% of the patients achieved clinical remission.  Changes in DAS 28 (CRP) remission rates for the <2 and ≥2 groups at 4, 24, and 52 weeks were 29% vs. 39%, 69% vs. 60%, and 83% vs. 65%, respectively. Similarly, changes in DAS 28 (CRP) in the N and S groups were 34% vs 41%, 67% vs 51%, and 74% vs 62%, respectively; in the ≥10 and < 10 mg groups, they were 43% vs 13%, 72% vs 25%, and 77% vs 46%, respectively, showing that the values were significantly high in the ≥ 10 group at all the time points. Moreover, HAQ remission rate for the overall patients at 52 weeks was 82%, and treatment continuation rate was 72%. Excluding the patients that discontinued treatment for reasons such as hospital transfer, of the 82% on concomitant MTX treatment, response was good in 90%.

Conclusion: With ADA, remission could be induced from very early on in the treatment at 4 weeks in about 40% of the patients.  The best way to apply ADA treatment is to use it concomitantly with an adequate dose of MTX in early-stage RA and Bio Naïve patients. By so doing, the potential of ADA can be exploited maximally.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-strategy-for-maximizating-the-effect-of-adalimumab-in-japanese-patients-with-rheumatoid-arthritis-retrospective-analyses-of-data-collected-from-the-patient-treated-with-adalimumab-in-routi/