Objectives Evaluate the effect of anakinra treatment on joint destruction in 1) patients completing a previous 6 months of anakinra treatment, and 2) patients completing 24 weeks of placebo.
Methods 472 Patients with RA entered a 24 week, randomised clinical trial and received placebo or anakinra 30, 75 or 150 mg daily. On completing this phase, patients receiving placebo were re-randomised to one of the treatment groups and patients receiving anakinra continued treatment for a further 24 week extension study. Radiographs, obtained at 0, 24 and 48 weeks, were evaluated for joint damage using a modified Sharp method (Genant AJR ‘00).
Results For those patients who rolled over to treatment with anakinra after 6 months of placebo, all three anakinra dose groups showed significant reduction in the rate of joint destruction. Patients who received the same dose of anakinra for the entire 12 months showed an accelerated benefit by slowing radiographic progression in the second 6 months (75 and 150 mg).
Conclusion In a 24 week study of RA, anakinra significantly reduced the rate of progressive joint damage. When treatment was maintained for a further 24 weeks, the rate of progressive joint damage was significantly slower compared to the first 24 week period.
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