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Should We Use bDMARDs as an Induction Therapy in Early and Severe Rheumatoid Arthritis? Results at 5 years from the ERA UCLouvain Brussels Cohort.
Sapart, Emilie; Sokolova, Tatiana; de Montjoye, Stéphanie; Dierckx, Stéphanie; Nzeusseu, Adrien; Avramovska, Aleksandra; Meric de Bellefon, Laurent; Durez, Patrick.
Afiliación
  • Sapart E; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • Sokolova T; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • de Montjoye S; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • Dierckx S; Rheumatology, CHU Mont-Godinne, Mont-Godinne, Belgium.
  • Nzeusseu A; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • Avramovska A; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • Meric de Bellefon L; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium.
  • Durez P; Department of Rheumatology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 10, Avenue Hippocrate, 1200, Brussels, Belgium. patrick.durez@uclouvain.be.
Rheumatol Ther ; 10(4): 875-886, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37183237
INTRODUCTION: This study sought to analyze the benefit of an early induction therapy with a biological disease-modifying anti-rheumatic drugs (bDMARD) during the first year of treatment with a 5-year follow-up in early rheumatoid arthritis (ERA). METHODS: We included ERA patients from the UCLouvain Brussels cohort who met the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2010 classification criteria and were naïve to DMARDs. ERA patients were divided into two groups according to whether they received an induction bDMARD therapy or a standard therapy with methotrexate (MTX). Clinical response after the induction treatment at 6 and 12 months followed by a MTX maintenance therapy at 36 and 60 months was evaluated. RESULTS: Data from 470 ERA patients were collected, 189 received a bDMARD and 281 initiated MTX alone. In the bDMARD group, disease activity and HAQ were higher at baseline. A total of 391 patients were followed up to 5 years. We then divided each group into two subgroups according to the last treatment they received at 5 years: bDMARD > MTX (n = 95), bDMARD > bDMARD (n = 59); MTX > MTX (n = 134), MTX > bDMARD (n = 103). During the induction, we observed a clinical response with a large number of patients achieving DAS28-CRP remission. According to a treat-to-target (T2T) approach, remission rate was stable on MTX monotherapy or rescued by the addition or prolongation of a bDMARD. Interestingly, bDMARD followed by a MTX maintenance therapy experienced a stable and sustained DAS28-CRP remission rate in 53% of the ERA patients at year 5. CONCLUSIONS: Long-term remission is an achievable goal in ERA. Our results suggest that a bDMARD induction therapy followed by MTX maintenance therapy could be an interesting option.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Rheumatol Ther Año: 2023 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Rheumatol Ther Año: 2023 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido