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Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial

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Title: Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial
Authors: Tanaka, Yoshiya Browse this author →KAKEN DB
Oba, Koji Browse this author
Koike, Takao Browse this author →KAKEN DB
Miyasaka, Nobuyuki Browse this author →KAKEN DB
Mimori, Tsuneyo Browse this author →KAKEN DB
Takeuchi, Tsutomu Browse this author →KAKEN DB
Hirata, Shintaro Browse this author →KAKEN DB
Tanaka, Eiichi Browse this author
Yasuoka, Hidekata Browse this author
Kaneko, Yuko Browse this author →KAKEN DB
Murakami, Kosaku Browse this author →KAKEN DB
Koga, Tomohiro Browse this author →KAKEN DB
Nakano, Kazuhisa Browse this author →KAKEN DB
Amano, Koichi Browse this author →KAKEN DB
Ushio, Kazuyasu Browse this author
Atsumi, Tatsuya Browse this author →KAKEN DB
Inoo, Masayuki Browse this author
Hatta, Kazuhiro Browse this author
Mizuki, Shinichi Browse this author
Nagaoka, Shouhei Browse this author
Tsunoda, Shinichiro Browse this author
Dobashi, Hiroaki Browse this author →KAKEN DB
Horie, Nao Browse this author
Sato, Norihiro Browse this author
Issue Date: Jan-2020
Publisher: BMJ Publishing Group
Journal Title: Annals of the rheumatic diseases
Volume: 79
Issue: 1
Start Page: 94
End Page: 102
Publisher DOI: 10.1136/annrheumdis-2019-216169
PMID: 31630117
Abstract: Objectives The aim of this study is to determine whether the 'programmed' infliximab (IFX) treatment strategy (for which the dose of IFX was adjusted based on the baseline serum tumour necrosis factor alpha (TNF-alpha)) is beneficial to induction of clinical remission after 54 weeks and sustained discontinuation of IFX for 1 year. Methods In this multicentre randomised trial, patients with IFX-naive rheumatoid arthritis with inadequate response to methotrexate were randomised to two groups; patients in programmed treatment group received 3 mg/kg IFX until week 6 and after 14 weeks the dose of IFX was adjusted based on the baseline levels of serum TNF-alpha until week 54; patients in the standard treatment group received 3 mg/kg of IFX. Patients who achieved a simplified disease activity index (SDAI) <= 3.3 at week 54 discontinued IFX. The primary endpoint was the proportion of patients who sustained discontinuation of IFX at week 106. Results A total of 337 patients were randomised. At week 54, 39.4% (67/170) in the programmed group and 32.3% (54/167) in the standard group attained remission (SDAI <= 3.3). At week 106, the 1-year sustained discontinuation rate was not significantly different between two groups; the programmed group 23.5% (40/170) and the standard group 21.6% (36/167), respectively (2.2% difference, 95% CI -6.6% to 11.0%; p=0.631). Baseline SDAI <26.0 was a statistically significant predictor of the successfully sustained discontinuation of IFX at week 106. Conclusion Programmed treatment strategy did not statistically increase the sustained remission rate after 1 year discontinuation of IFX treatment.
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Type: article
URI: http://hdl.handle.net/2115/76845
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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