PMID- 15308515
OWN - NLM
STAT- MEDLINE
DCOM- 20040914
LR  - 20181113
IS  - 0003-4967 (Print)
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 63
IP  - 9
DP  - 2004 Sep
TI  - A randomised comparative study of the short term clinical and biological effects 
      of intravenous pulse methylprednisolone and infliximab in patients with active 
      rheumatoid arthritis despite methotrexate treatment.
PG  - 1069-74
AB  - OBJECTIVES: To compare the short term clinical and biological effects of 
      intravenous (i.v.) pulse methylprednisolone (MP) and infliximab (IFX) in patients 
      with severe active rheumatoid arthritis (RA) despite methotrexate (MTX) 
      treatment. METHODS: Patients with active RA despite MTX treatment were randomly 
      allocated to receive a single i.v. infusion of MP (1 g) or three i.v. infusions 
      of IFX (3 mg/kg) on weeks 0, 2, and 6. Patients were "blindly" evaluated for 
      disease activity measures. Quality of life (QoL) was evaluated through the SF-36 
      health survey. Serum matrix metalloproteinase-3 (MMP-3) titres were measured at 
      baseline, weeks 2 and 6. RESULTS: Compared with baseline, significant improvement 
      was noted in all activity measures, including serum C reactive protein (CRP) 
      titres, in the IFX group only. At week 14, 6/9 (67%) and 4/9 (44%) IFX patients 
      met the ACR20 and 50 response criteria, while this was the case in only 1/12 (8%) 
      and 0/12 (0%) MP patients, respectively (p<0.05). None of the QoL scales improved 
      with MP treatment, whereas some did so in the IFX group. Serum MMP-3 titres 
      significantly decreased (41% drop) at week 6 in the IFX group, while no changes 
      were seen in patients given MP. CONCLUSION: This short term randomised 
      comparative study demonstrates that TNF blockade is better than MP pulse therapy 
      in a subset of patients with severe refractory RA, with improvement in not only 
      clinical parameters of disease activity but also biological inflammatory indices, 
      such as serum CRP and MMP-3 titres.
FAU - Durez, P
AU  - Durez P
AD  - Rheumatology Department, Cliniques Universitaires Saint-Luc, Universite 
      catholique de Louvain, Bruxelles, Belgium.
FAU - Nzeusseu Toukap, A
AU  - Nzeusseu Toukap A
FAU - Lauwerys, B R
AU  - Lauwerys BR
FAU - Manicourt, D H
AU  - Manicourt DH
FAU - Verschueren, P
AU  - Verschueren P
FAU - Westhovens, R
AU  - Westhovens R
FAU - Devogelaer, J-P
AU  - Devogelaer JP
FAU - Houssiau, F A
AU  - Houssiau FA
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Interleukin-6)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - B72HH48FLU (Infliximab)
RN  - EC 3.4.24.17 (Matrix Metalloproteinase 3)
RN  - X4W7ZR7023 (Methylprednisolone)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
CIN - Ann Rheum Dis. 2005 Jan;64(1):171-2; author reply 172. PMID: 15608329
CIN - Ann Rheum Dis. 2005 Mar;64(3):512; author reply 512. PMID: 15708914
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/blood/*drug therapy/rehabilitation
MH  - C-Reactive Protein/metabolism
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Infliximab
MH  - Interleukin-6/blood
MH  - Male
MH  - Matrix Metalloproteinase 3/blood
MH  - Methotrexate/therapeutic use
MH  - Methylprednisolone/*therapeutic use
MH  - Middle Aged
MH  - Quality of Life
MH  - Severity of Illness Index
MH  - Single-Blind Method
PMC - PMC1755125
EDAT- 2004/08/17 10:00
MHDA- 2004/09/15 05:00
PMCR- 2007/09/01
CRDT- 2004/08/17 10:00
PHST- 2004/08/17 10:00 [pubmed]
PHST- 2004/09/15 05:00 [medline]
PHST- 2004/08/17 10:00 [entrez]
PHST- 2007/09/01 00:00 [pmc-release]
AID - 63/9/1069 [pii]
AID - 10.1136/ard.2003.012914 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2004 Sep;63(9):1069-74. doi: 10.1136/ard.2003.012914.