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

Tanaka, Yoshiya; Oba, Koji; Koike, Takao; Miyasaka, Nobuyuki; Mimori, Tsuneyo; Takeuchi, Tsutomu; Hirata, Shintaro; Tanaka, Eiichi; Yasuoka, Hidekata; Kaneko, Yuko; Murakami, Kosaku; Koga, Tomohiro; Nakano, Kazuhisa; Amano, Koichi; Ushio, Kazuyasu; Atsumi, Tatsuya; Inoo, Masayuki; Hatta, Kazuhiro; Mizuki, Shinichi; Nagaoka, Shouhei; Tsunoda, Shinichiro; Dobashi, Hiroaki; Horie, Nao; Sato, Norihiro

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

Tanaka, Yoshiya; Oba, Koji; Koike, Takao et al.

Annals of the rheumatic diseases, 2020, 79(1), 94-102

Permalink : https://hdl.handle.net/2115/76845

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アクセス権	open access
URI	https://hdl.handle.net/2115/76845
タイトル	Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial
著者	Tanaka, Yoshiya ; Oba, Koji ; Koike, Takao ; Miyasaka, Nobuyuki ; Mimori, Tsuneyo ; Takeuchi, Tsutomu ; Hirata, Shintaro ; Tanaka, Eiichi ; Yasuoka, Hidekata ; Kaneko, Yuko ; Murakami, Kosaku ; Koga, Tomohiro ; Nakano, Kazuhisa ; Amano, Koichi ; Ushio, Kazuyasu ; Atsumi, Tatsuya ; Inoo, Masayuki ; Hatta, Kazuhiro ; Mizuki, Shinichi ; Nagaoka, Shouhei ; Tsunoda, Shinichiro ; Dobashi, Hiroaki ; Horie, Nao ; Sato, Norihiro
e-Rad_Researcher 30248562 著者名 Tanaka, Yoshiya
著者名 Oba, Koji
e-Rad_Researcher 80146795 著者名 Koike, Takao
e-Rad_Researcher 30157622 著者名 Miyasaka, Nobuyuki
e-Rad_Researcher 10157589 著者名 Mimori, Tsuneyo
e-Rad_Researcher 50179610 著者名 Takeuchi, Tsutomu
e-Rad_Researcher 90525461 著者名 Hirata, Shintaro
著者名 Tanaka, Eiichi
著者名 Yasuoka, Hidekata
e-Rad_Researcher 60317112 著者名 Kaneko, Yuko
e-Rad_Researcher 70599927 著者名 Murakami, Kosaku
e-Rad_Researcher 90537284 著者名 Koga, Tomohiro
e-Rad_Researcher 50406500 著者名 Nakano, Kazuhisa
e-Rad_Researcher 00175928 著者名 Amano, Koichi
著者名 Ushio, Kazuyasu
e-Rad_Researcher 20301905 著者名 Atsumi, Tatsuya
著者名 Inoo, Masayuki
著者名 Hatta, Kazuhiro
著者名 Mizuki, Shinichi
著者名 Nagaoka, Shouhei
著者名 Tsunoda, Shinichiro
e-Rad_Researcher 50380176 著者名 Dobashi, Hiroaki
著者名 Horie, Nao
著者名 Sato, Norihiro
言語	英語
発行日	2020-01
出版者	BMJ Publishing Group
収録物名	Annals of the rheumatic diseases
巻(号)	79(1)
ページ	94-102
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	0003-4967
EISSN	1468-2060
NCID	AA12778137
関連情報	PMID 31630117
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1136/annrheumdis-2019-216169