PMID- 19505397
OWN - NLM
STAT- MEDLINE
DCOM- 20090723
LR  - 20170214
IS  - 0394-6320 (Print)
IS  - 0394-6320 (Linking)
VI  - 22
IP  - 2
DP  - 2009 Apr-Jun
TI  - Imaging progression despite clinical remission in early rheumatoid arthritis 
      patients after etanercept interruption.
PG  - 447-54
AB  - The aim of this preliminary study is to evaluate clinical and imaging response in 
      twenty patients with early Rheumatoid Arthritits (eRA) treated with Etanercept 
      (Etn) + Methotrexate (Mtx) and to investigate whether clinical and MRI remission 
      may be maintained after biological therapy interruption. Assessment included: 
      radiography, Visser score and anti-CCP antibodies at baseline; disease activity 
      score in 44 joints (DAS44), rheumatoid factor (RF), Magnetic Resonance Imaging 
      (MRI) of hands and wrists at baseline (T0), 12 (T1), and 24 months (T2). MRI was 
      scored for synovitis, bone oedema and erosions (OMERACT study); patients who 
      reached clinical and imaging remission at T1 were considered eligible for 
      interrupting Etn. At T1 8/20 (40 percent) patients showed a total remission, 
      DAS44 from 5 (T0) to 1.4 (T1); p<0.02, whereas the other 12/20 (60 percent) 
      showed an improvement, without complete remission, DAS44 from 4.8 (T0) to 2.8 
      (T1); p<0.05. Etn was therefore interrupted in the first group of patients (group 
      A), whereas it was continued in the other group (group B). At T2, group A 
      maintained clinical remission and group B showed further not significant DAS44 
      reduction from T1. At T1, a significant reduction in synovitis, bone oedema and 
      total score (p<0.01) was observed both in group A and in group B. At T2, group A 
      showed an increase in all the MRI scores that was significant for the synovitis 
      and total score, whereas group B exhibited a further not significant reduction. 
      This preliminary study reports an excellent clinical and imaging response in eRA 
      patients treated with Etn with total remission in 40 percent of them after a 
      1-year therapy period. However, it indicates that joint damage may progress, 
      despite a sustained clinical remission, after Etn suspension.
FAU - Lagana, B
AU  - Lagana B
AD  - Department of Medical Sciences, Sapienza University of Rome, 2nd School of 
      Medicine, S. Andrea University Hospital, Rome, Italy. blagana@infinito.it
FAU - Picchianti Diamanti, A
AU  - Picchianti Diamanti A
FAU - Ferlito, C
AU  - Ferlito C
FAU - Germano, V
AU  - Germano V
FAU - Migliore, A
AU  - Migliore A
FAU - Cremona, A
AU  - Cremona A
FAU - Argento, G
AU  - Argento G
FAU - David, V
AU  - David V
FAU - Salemi, S
AU  - Salemi S
FAU - D'Amelio, R
AU  - D'Amelio R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Int J Immunopathol Pharmacol
JT  - International journal of immunopathology and pharmacology
JID - 8911335
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - OP401G7OJC (Etanercept)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/*administration & dosage
MH  - Arthritis, Rheumatoid/diagnosis/*drug therapy/pathology
MH  - Arthrography
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Edema/drug therapy/pathology
MH  - Etanercept
MH  - Female
MH  - Hand Joints/*drug effects/pathology
MH  - Humans
MH  - Immunoglobulin G/*administration & dosage
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Methotrexate/administration & dosage
MH  - Middle Aged
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Receptors, Tumor Necrosis Factor/*administration & dosage
MH  - Remission Induction
MH  - Severity of Illness Index
MH  - Synovitis/drug therapy/pathology
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/06/10 09:00
MHDA- 2009/07/25 09:00
CRDT- 2009/06/10 09:00
PHST- 2009/06/10 09:00 [entrez]
PHST- 2009/06/10 09:00 [pubmed]
PHST- 2009/07/25 09:00 [medline]
AID - 21 [pii]
AID - 10.1177/039463200902200221 [doi]
PST - ppublish
SO  - Int J Immunopathol Pharmacol. 2009 Apr-Jun;22(2):447-54. doi: 
      10.1177/039463200902200221.