The Efficacy of Infliximab Plus Methotrexate in Patients with Active Rheumatoid Arthritis in North of Iraq: 5 year Extended Study

Background and objectives: Anti-Tumor necrosis factor agents are among the most effective therapies for Rheumatoid Arthritis, however, their optimal use is yet to be determined.In this 5 year open-labeled study attempted remission induction using standard therapy with infliximab in patients with po...

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Bibliographic Details
Main Author: Niaz Jawad Albarzinji
Format: Article
Language:English
Published: Kurdistan Higher Council Of Medical Specialties 2023-03-01
Series:Advanced Medical Journal
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Online Access:https://amj.khcms.edu.krd/index.php/main/article/view/140
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Summary:Background and objectives: Anti-Tumor necrosis factor agents are among the most effective therapies for Rheumatoid Arthritis, however, their optimal use is yet to be determined.In this 5 year open-labeled study attempted remission induction using standard therapy with infliximab in patients with poor response to ordinary disease modifying anti-Rheumatic drugs. Methods: Patients responding inadequately to methotrexate and at least one other disease-modi- fying anti-rheumatic drug were enrolled into a 24-week, controlled study with infliximab plus methotrexate or placebo plus methotrexate and some were enrolled in a subsequent open-label extension. The efficacy were evaluated by measuring the disease activity by using DAS-28(disease activity score in 28 points) and functional evaluation by using the health assessment questioner (HAQ). Results: Among 250 patients in the original trial, 220 received at least one dose of infliximab and were evaluated. At the time of analysis 160/ 220 (72.7%) patients had remained in the study and received treatment for a mean of 4.5 years. Withdrawals were for lack of efficacy (24%), adverse events (36%), and other reasons (50%). In 160 patients who completed 5 years treatment efficacy achieved in 6 months was maintained at 5 years. 45% achieved clinical remission (DAS28<2.6), and 27% had no physical function abnormalities (HAQ=0). Results were similar for 160 patients who received treatment for 3-5 years. Conclusions: In patients with persistently active Rheumatoid Arthritis despite Methotraxate therapy, repeated doses of infliximab in combination with methotraxate provided clinical remissions with functional and quality of life benefits were sustained.
ISSN:2958-8979
2957-3580