Objectives To assess the effect of ankinra on progressive joint damage in patients with rheumatoid arthritis after 12 months of treatment.
Methods 472 patients were randomised to a 24 week study. On completing the 24 week, placebo-controlled, randomised clinical trial, patients receiving anakinra 30, 75 or 150 mg daily continued blinded treatment for a further 24 weeks. Patients originally randomised to placebo were re-randomised to blinded treatment with one of the 3 anakinra doses for an additional 24 weeks resulting in a blinded cohort of patients (N = 309) followed for up to 1 year by radiographic assessments, using a modified Sharp method (Genant A&R, 41:1583, 98).
Results Treatment with 75 or 150 mg anakinra was significantly superior in terms of reducing joint destruction after 1 year, when compared to the group of patients originally randomised to placebo. This analysis demonstrated a dose proportional relationship with increasing doses of anakinra providing superior reduction of joint destruction when measured by a modified Sharp score.
Conclusion Anakinra provides a statistically significant reduction in joint destruction, compared with patients originally randomised to placebo after 1 year of treatment. The reduction in joint destruction was dose proportional.
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