TY - JOUR T1 - Continuation of Methotrexate Resulted in Better Clinical and Radiographic Outcomes Than Discontinuation upon Starting Etanercept in Patients with Rheumatoid Arthritis: 52-week Results from the JESMR Study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.110014 SP - jrheum.110014 AU - Hideto Kameda AU - Katsuaki Kanbe AU - Eri Sato AU - Yukitaka Ueki AU - Kazuyoshi Saito AU - Shouhei Nagaoka AU - Toshihiko Hidaka AU - Tatsuya Atsumi AU - Michishi Tsukano AU - Tsuyoshi Kasama AU - Shunichi Shiozawa AU - Yoshiya Tanaka AU - Hisashi Yamanaka AU - Tsutomu Takeuchi Y1 - 2011/05/15 UR - http://www.jrheum.org/content/early/2011/05/12/jrheum.110014.abstract N2 - Objective The aim of the Efficacy and Safety of Etanercept on Active Rheumatoid Arthritis Despite Methotrexate Therapy in Japan (JESMR) study is to compare the efficacy of continuation versus discontinuation of methotrexate (MTX) when starting etanercept (ETN) in patients with active rheumatoid arthritis (RA). Methods In total, 151 patients with active RA who had been taking MTX were randomized to either ETN 25 mg twice a week with 6–8 mg/week MTX (the E+M group), or ETN alone (the E group). The primary endpoint at Week 52 was the radiographic progression assessed by van der Heijde-modified Sharp score. Results The mean progression in total score at Week 52 was not significantly different, statistically, between the E+M group and the E group (0.8 vs 3.6, respectively; p = 0.06). However, a significant difference was observed in radiographic progression between Weeks 24 and 52 (0.3 vs 2.5; p = 0.03), and the mean progression of the erosion score was negative in the E+M group, which was significantly better than the E group at Week 52 (–0.2 vs 1.8; p = 0.02). Clinically, the cumulative probability plot of the American College of Rheumatology (ACR)-N values at Week 52 clearly demonstrated a superior response in the E+M group than in the E group. ACR20, 50, and 70 response rates at Week 52 in the E+M group (86.3%, 76.7%, and 50.7%) were significantly greater than those in the E group (63.8%; p = 0.003, 43.5%; p < 0.0001 and 29.0%; p = 0.01, respectively). Conclusion MTX should be continued when starting ETN in patients with active RA. (ClinicalTrials.gov: NCT00688103) ER -