Combination Therapy Might Allow Medication Tapering or Cessation in RA Patients

About 30% of patients with early moderate-to-severe rheumatoid arthritis were able to taper or stop therapy after aggressive treatment.

Treating patients with rheumatoid arthritis (RA) has been revolutionized by biologic therapies, but these drugs are costly (often, >US$30,000 annually). Lower-cost options are triple therapy with hydroxychloroquine, sulfasalazine, and methotrexate (NEJM JW Gen Med Oct 23 2012 and NEJM JW Gen Med Sep 10 2013) and reducing or even stopping biologic therapies.

In this manufacturer-sponsored study, 306 patients with early (duration, <12 months) moderate-to-severe RA were treated initially with weekly etanercept (Enbrel; 50 mg) plus methotrexate for 1 year. The 193 patients who achieved low disease activity or remission were randomized to receive weekly etanercept (25 mg) plus methotrexate, placebo plus methotrexate, or double placebo for another…

Reviewing Author

Jonathan S. Coblyn, MD

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Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Combination Therapy Might Allow Medication Tapering or Cessation in RA Patients

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Reviewing Author