Abstract | OBJECTIVE: METHOD: 160 patients with rheumatoid arthritis (RA), PsA, or AS with sustained minimal disease activity (MDA) were enrolled in this 18-month, open-label, randomized controlled trial. The intervention group doubled the dosing interval at baseline and discontinued etanercept 6 months later. The control group continued the standard dose for 6 months and doubled the dosing-interval thereafter. The primary outcome was the proportion of patients maintaining MDA at 6 month follow-up. RESULTS: At 6 months, MDA status was maintained in 47 patients (63%) in the intervention group and 56 (74%) in the control group (p = 0.15), with comparable results in all rheumatic diseases. And median etanercept concentrations decreased from 1.50 µg/mL (interquartile range 1.06- 2.65) to 0.46 µg/mL (0.28-0.92). In total, 40% discontinued etanercept successfully with maintained MDA for at least 6 months. CONCLUSION:
Etanercept tapering can be done without losing efficacy in RA, PsA, and AS patients in sustained MDA. A substantial proportion of patients could stop etanercept for at least 6 months. In many patients, low drug concentrations proved sufficient to control disease activity. However, the risk of minor and major flares is substantial, even in patients continuing standard dosing.
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Authors | J Ruwaard, M J L' Ami, E L Kneepkens, Clm Krieckaert, M T Nurmohamed, F Hooijberg, Awr van Kuijk, J C van Denderen, L Burgemeister, T Rispens, M Boers, G J Wolbink |
Journal | Scandinavian journal of rheumatology
(Scand J Rheumatol)
Vol. 52
Issue 2
Pg. 129-136
(03 2023)
ISSN: 1502-7732 [Electronic] England |
PMID | 35234569
(Publication Type: Randomized Controlled Trial, Journal Article)
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Chemical References |
- Etanercept
- Antirheumatic Agents
- Receptors, Tumor Necrosis Factor
- Immunoglobulin G
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Topics |
- Humans
- Etanercept
(therapeutic use)
- Spondylitis, Ankylosing
(drug therapy)
- Arthritis, Psoriatic
(drug therapy)
- Antirheumatic Agents
- Receptors, Tumor Necrosis Factor
(therapeutic use)
- Immunoglobulin G
(therapeutic use)
- Arthritis, Rheumatoid
(drug therapy)
- Rheumatic Diseases
(drug therapy)
- Treatment Outcome
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