Impact of methotrexate dose on efficacy of adalimumab in Japanese patients with rheumatoid arthritis: Results from registered data analyses. Issue 1 (2nd January 2017)

• Record Type: Journal Article
• Authors: Nakashima, Yasuharu; Miyahara, Hisaaki; Kondo, Masakazu; Fukuda, Takaaki; Harada, Hiroshi; Haraguchi, Akihisa; Inoue, Yasushi; Ishinishi, Takashi; Maekawa, Masayuki; Maeyama, Akira; Nakashima, Munetoshi; Shono, Eisuke; Suematsu, Eiichi; Shimauchi, Takashi; Tsuru, Tomomi; Tsukamoto, Hiroshi; Yoshizawa, Shigeru; Yoshizawa, Seiji; Iwamoto, Yukihide
• Is Part Of: Modern rheumatology. Volume 27:Issue 1(2017)
• Page Start: 15
• Page End: 21
• Publication Date: 2017-01-02
• Subjects: Adalimumab -- Clinical practice -- Methotrexate -- Remission -- Rheumatoid arthritis; Rheumatology -- Periodicals; 616.723005
• DOI: 10.3109/14397595.2016.1170958
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objective : Upper limit of methotrexate (MTX) for patients with rheumatoid arthritis (RA) was recently increased from 8 to 16 mg/week in Japan. We therefore examined the effect of concomitant MTX dose on the efficacy of adalimumab (ADA) in clinical practice. Method : Sixty-one consecutive RA patients treated with ADA were followed for minimum 52 weeks and retrospectively compared by MTX dose; patients receiving concomitant MTX of 10 mg/week or more (MTX ≥10 mg group) and <10 mg/week (MTX <10 mg group). Disease activity and remission were evaluated by the disease activity score 28 (DAS28) criteria. Results : The MTX ≥10 mg group consistently showed better improvement in DAS28 and resulted in more patients (52.8%) with DAS28-remission compared with the MTX <10 mg group (26.1%). Multivariate analysis showed that MTX ≥10 mg had a significant effect on DAS28 remission with odds ratio of 5.12. ADA retention rate was 72.2% in MTX ≥10 mg group compared with 52.0% in MTX <10 mg group. Discontinuation of ADA due to adverse events were comparable in the MTX ≥10 mg and MTX <10 mg groups (11.1% vs. 12.0%). Conclusions : These findings support the critical role of concomitant MTX in the efficacy of ADA, and recommend use of MTX ≥10 mg in Japanese RA patients.