Targeting sustained and stringently defined clinical remission in patients with moderately active rheumatoid arthritis (RA) receiving full-dose combination therapy with etanercept plus methotrexate before considering dose or regimen changes may help improve the likelihood that patients will remain in clinical remission 1 year after the changes are made.
Targeting sustained and stringently defined clinical remission in patients with moderately active rheumatoid arthritis (RA) receiving full-dose combination therapy with etanercept plus methotrexate before considering dose or regimen changes may help improve the likelihood that patients will remain in clinical remission 1 year after changes are made, according to a new analysis of data from the 2013 PRESERVE trial.
Patients with moderately active RA who are younger and have a lower body mass index (BMI), a lower Health Assessment Questionnaire (HAQ) score, and lower disease activity at baseline are more likely to achieve remission when receiving combination etanercept and methotrexate induction therapy, Josef S. Smolen, MD, and colleagues concluded. The researchers said their findings, reported in the January 16, 2018, issue of Arthritis Research & Therapy, may provide important information needed to help guide clinicians’ decision making as they treat patients to remission and beyond.
Smolen and colleagues also report that patients with RA who fail to achieve sustained remission with induction therapy, and those with worse disease activity and patient-reported outcomes (PROs) early after initiating maintenance therapy with a full-dose or reduced-dose etanercept-methotrexate regimen or methotrexate monotherapy, were most likely to lose remission across all treatment arms of the original PRESERVE trial.
The PRESERVE trial was an induction/maintenance study of etanercept that assessed the consequences of etanercept dose reduction or withdrawal in approximately 600 adults with moderately active RA who achieved low disease activity (LDA) after 36 weeks of treatment with full-dose etanercept combined with methotrexate. The current study presents post-hoc analyses of PRESERVE data to identify potential predictive markers for remission induction and loss after modification of etanercept dosing. It uses Disease Activity Score in 28 joints (DAS28), based on erythrocyte sedimentation rate (ESR) less than 2.6 to indicate remission, as well as American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) remission criteria including the Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI).
The data in the current report reveal that a large proportion of patients with moderate RA were able to achieve DAS28 remission with full-dose combination etanercept-plus-methotrexate therapy by the end of the open-label period of the PRESERVE study. However, withdrawal of etanercept after achievement of response resulted in a loss of remission in many patients in the double-blind period of the study.
These findings indicate that depth of disease control is an important predictor of remission loss, the researchers said. “This result underscores and reinforces the current treat-to-target approach and the importance of adjusting treatment in patients who are not achieving the lowest levels of disease activity currently recommended in ACR/EULAR treatment guidelines, as it suggests that the depth and duration of response are relevant,” they stress. “Predictors identified for the maintenance of SDAI and CDAI remission (with the exception of failure to achieve sustained SDAI or CDAI) further support the conclusion of a better outcome with lower disease activity and maintenance of a good response at the time of withdrawal.”
AMCP Posters Tackle Interchangeability and Medicaid, Factors Driving Biosimilar Access
April 24th 2024Two posters from the Academy of Managed Care Pharmacy (AMCP) annual meeting explore how an interchangeable insulin glargine biosimilar plays into Medicaid budgets and the top factors driving access to biosimilars.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
Global Biosimilar Market Projected to Reach $1.3 Trillion by 2032
April 11th 2024The global biosimilar market is projected to surge from $25.1 billion in 2022 to approximately $1.3 trillion by 2032, with a compound annual growth rate of 17.6%, driven mainly by the increasing prevalence of cancer and the cost-effectiveness of biosimilars, as outlined in a report by Towards Healthcare.
Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars
April 16th 2023What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.
Physician and Patient Perspectives After Starting or Switching to Amgevita in IBD
March 23rd 2024A real-world study surveying physicians and patients on adalimumab biosimilar ABP 501 (Amgevita) in inflammatory bowel disease (IBD) found both patients initiating ABP 501 and those who had switched from the reference product had higher satisfaction levels.