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Research ArticleArticle

Less Radiographic Progression with Adalimumab Plus Methotrexate Versus Methotrexate Monotherapy Across the Spectrum of Clinical Response in Early Rheumatoid Arthritis

Paul Emery, Mark C. Genovese, Ronald van Vollenhoven, John T. Sharp, Kaushik Patra and Eric H. Sasso
The Journal of Rheumatology April 2009, jrheum.081018; DOI: https://doi.org/10.3899/jrheum.081018
Paul Emery
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Mark C. Genovese
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Ronald van Vollenhoven
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John T. Sharp
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Kaushik Patra
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Eric H. Sasso
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This article has corrections. Please see:

  • Errata - June 01, 2010
  • Errata - May 01, 2010

Abstract

Objective To determine the relationship between radiographic progression and clinical response for adalimumab plus methotrexate (MTX) versus either monotherapy in patients with early rheumatoid arthritis (RA) in the PREMIER study.

Methods Patients with early RA who received adalimumab plus MTX (n = 240), adalimumab (n = 222), or MTX (n = 216) were grouped by American College of Rheumatology (ACR) response, 28-joint Disease Activity Score (DAS28), or remission-like state [tender joint count (TJC) = 0; DAS28 < 2.6; swollen joint count = 0;ACR100] at 26 and 104 weeks. Radiographic progression was assessed by cumulative probability plots, mean changes in total Sharp score (ΔTSS), and percentages of progressors (ΔTSS > 0.5).

Results Across the spectrum of clinical outcomes, including ACR20 nonresponses and remission- like responses, therapy with adalimumab plus MTX permitted less radiographic progression at Weeks 26 and 104 than MTX monotherapy. Adalimumab monotherapy was generally intermediate. A strong, proportional relationship was observed between clinical response and radiographic efficacy only for MTX monotherapy. The monotherapies approximated the radiographic efficacy of adalimumab plus MTX only among remission-like responders, although progression was significantly greater with MTX monotherapy versus adalimumab plus MTX for patients with TJC = 0. Concurrent clinical (DAS28 < 2.6) and radiographic (ΔTSS ≤ 0.5) remission was significantly more frequent at Week 104 with adalimumab plus MTX (45%) than with adalimumab (25%) or MTX (18%) monotherapy.

Conclusion In patients with early RA, adalimumab plus MTX resulted in less radiographic progression than MTX monotherapy across the spectrum of clinical response, including ACR20 nonresponses and remission-like responses.

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The Journal of Rheumatology
Vol. 50, Issue 9
1 Sep 2023
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Less Radiographic Progression with Adalimumab Plus Methotrexate Versus Methotrexate Monotherapy Across the Spectrum of Clinical Response in Early Rheumatoid Arthritis
Paul Emery, Mark C. Genovese, Ronald van Vollenhoven, John T. Sharp, Kaushik Patra, Eric H. Sasso
The Journal of Rheumatology Apr 2009, jrheum.081018; DOI: 10.3899/jrheum.081018

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Less Radiographic Progression with Adalimumab Plus Methotrexate Versus Methotrexate Monotherapy Across the Spectrum of Clinical Response in Early Rheumatoid Arthritis
Paul Emery, Mark C. Genovese, Ronald van Vollenhoven, John T. Sharp, Kaushik Patra, Eric H. Sasso
The Journal of Rheumatology Apr 2009, jrheum.081018; DOI: 10.3899/jrheum.081018
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