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FRI0118 Does Attainment of Clinical Remission Lead to Comprehensive Disease Control in Rheumatoid Arthritis Patients?
  1. J.S. Smolen1,
  2. A. Kavanaugh2,
  3. I. Sainsbury3,
  4. S. Liu4,
  5. S. Florentinus4,
  6. E.C. Keystone5,
  7. P. Emery6
  1. 1Medical University of Vienna & Hietzing Hospital, Vienna, Austria
  2. 22University of California San Diego, La Jolla, United States
  3. 3AbbVie Ltd, Maidenhead, United Kingdom
  4. 4AbbVie Inc., North Chicago, United States
  5. 5Mount Sinai Hospital, University of Toronto, Toronto, Canada
  6. 6Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom

Abstract

Background The primary goal of treating rheumatoid arthritis (RA) is to maximize quality of life through control of signs and symptoms of disease, prevention of structural damage, and normalization of function.

Objectives To assess if patients (pts) who achieve clinical remission at wk 24/26 also achieve comprehensive disease control (CDC) at wk 52.

Methods CDC was defined as achievement of remission + absence of radiographic progression by modified total Sharp score (ΔmTSS≤0.5) between wks 24/26–52 + normal physical function by the health assessment questionnaire disability index (HAQ-DI<0.5). PREMIER enrolled MTX-naïve pts with early RA (mean RA duration 0.8 years [yr]). DE019 enrolled pts with established RA (mean RA duration 11 yr) who were MTX-inadequate responders (MTX-IR). In this post hoc analysis, CDC was assessed following 52 wk of treatment with adalimumab (ADA) 40 mg every other wk + methotrexate (MTX) or placebo (PBO)+MTX. Remission was defined as DAS28(CRP)<2.6 or Simplified Disease Activity Index (SDAI)≤3.3.

Results In early RA (PREMIER) DAS28 remission was achieved by 36.7%/19.0% (ADA+MTX/PBO+MTX) of pts; 23.2%/12.3% of pts achieved SDAI remission at wk 26. Of these, 51.0%/47.9% (ADA+MTX/PBO+MTX) in DAS28 remission achieved CDC and 58.1%/54.8% of pts in SDAI remission achieved CDC at wk 52 (table). In MTX-IR pts with established RA (DE019), fewer pts achieved DAS28 remission, 22.8%/4.7% (ADA+MTX/PBO+MTX) and SDAI remission, 10.4%/2.1% at wk 24, and fewer pts in remission achieved CDC at wk 52 (table). Among MTX-IR pts achieving DAS28<3.2 as a target instead of DAS28<2.6 at wk 24, 28%/19% (ADA+MTX/PBO+MTX) achieved CDC using DAS28<3.2 at wk 52. Among pts in either DAS28 or SDAI remission in both early and established RA, although mean ΔmTSS was small from wk 24/26 to wk 52, a subgroup of pts in each treatment group showed rapid radiographic progression (ΔmTSS≥1.5) between wk 24/26 and 52 (table).

Table 1

Conclusions Of those pts achieving remission at wk 26, more than one-third were in remission, had normal function, and no radiographic progression at wk 52. Nonetheless, a small subgroup of pts progresses rapidly highlighting the need to monitor the elements of CDC.

Acknowledgements AbbVie funded the studies (NCT00195663, PREMIER; NCT00195702, DE019), contributed to their design and was involved in the collection, analysis, and interpretation of the data, and in the writing, review, and approval of the publication. Medical writing support was provided by Kathleen V. Kastenholz, PharmD, MS, of AbbVie.

Disclosure of Interest J. Smolen Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Celgene, Glaxo, Janssen (Centocor), Lilly, Pfizer (Wyeth), Merck (Schering-Plough), Novo Nordisk, Roche, Samsung, Sandoz, and UCB, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Celgene, Glaxo, Janssen (Centocor), Lilly, Pfizer (Wyeth), Merck (Schering-Plough), Novo Nordisk, Roche, Samsung, Sandoz, and UCB, A. Kavanaugh Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, and UCB, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, and UCB, I. Sainsbury Shareholder of: AbbVie, Employee of: AbbVie, S. Liu Shareholder of: AbbVie, Employee of: AbbVie, S. Florentinus Shareholder of: AbbVie, Employee of: AbbVie, E. Keystone Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Janssen, Pfizer, Roche, and UCB, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Janssen, Pfizer, Roche, and UCB, Speakers bureau: AbbVie, Amgen, AstraZeneca, BMS, Janssen, Pfizer, Roche, and UCB, P. Emery Grant/research support from: AbbVie, BMS, Pfizer, Novartis, and Roche, Consultant for: AbbVie, BMS, Merck, Novartis, Pfizer, Roche, and UCB

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