| 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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