Combination of etanercept and methotrexate 'effective' in early rheumatoid arthritis
Published on 04 Mar 2010
Combination therapy with etanercept and methotrexate is an
effective treatment for patients with early active rheumatoid
arthritis, new trial data show.
Methotrexate is a
disease-modifying anti-rheumatic drug, or DMARD, and is used to
suppress the patient's immune system and reduce pain, swelling and
stiffness.
Etanercept belongs to a newer group of
'biological' therapies called anti-TNF drugs, pioneered and developed by the
Arthritis Research Campaign, which are designed to reduce joint
inflammation in patients with rheumatoid arthritis and some other
inflammatory diseases. It is usually only given to patients who are
not responding to DMARDs.
The latest results from
the COMET trial have been published in the journal Arthritis and
Rheumatism and show that the combination of etanercept and
methotrexate brought about radiographic remission in 90 per cent of
patients after two years.
More than half of the
542 patients involved in the trial (57 per cent) also experienced
clinical remission thanks to a reduction in joint pain and
swelling, while 62 per cent went into functional
remission.
The researchers found that patients
who took methotrexate alone for the first year of treatment and
added etanercept for the second year also benefited from a reduced
rate of radiographic progression; however, the effect was not as
impressive as in those patients who took both drugs from the
start.
Lead investigator Professor Paul Emery,
Arthritis Research Campaign professor of rheumatology at the
University of Leeds, said that the results were
"important" and may "set the standard
for the way physicians manage rheumatoid arthritis
overall".
"This study proposes
a new therapeutic window of opportunity in which early treatment of
rheumatoid arthritis with anti-TNF agents may not only modify the
underlying disease processes, but halt the destruction of joints
and prevent joint damage from getting worse over time," he
revealed.
The results follow previous one-year
data, published in the Lancet, which found that patients who
received both drugs were nearly three times less
likely to stop working than those who were given methotrexate
alone.
Professor Emery concluded: "By
stopping the progression of the disease early and preventing
permanent joint damage, patients with rheumatoid arthritis may
avoid the potential limitations of their
disease."
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