A recent controlled, randomized and open-label study in Scientific reports concluded that in active RA patients, methotrexate (MTX) when utilized along with etanercept biosimilar rhTNFR:Fc (recombinant human tumour necrosis factor-α receptor II:lgG Fc fusion protein injection) could effectively prevent impairment to the joint structure.

The study researchers explored the efficacy and safety of the combination of MTX therapy with maintenance or withdrawal of rhTNFR:Fc in active RA patients. A total of 89 patients with active RA were registered. In 52 weeks, patients were divided in groups as: MTX plus rhTNFR:Fc for a period of 52 weeks (32 patients), MTX plus rhTNFR:Fc for a period of 24 weeks (31 patients), or just MTX alone (26 patients).

The damage to the joint as assessed via van de Heijde modified Total Sharp Score (mTSS) was considered as the primary outcome. In the MTX plus rhTNFR:Fc24 group, 1 participant was lost to the follow-up. The mTSS CFB was lower in the rhTNFR:Fc pooled group than with MTX monotherapy at week 24 and 52 (Figure 1).

Figure 1: Primary outcome (mTSS CFB) at week 24 and 52 in the three groups.

Furthermore, elevated ACR50 and ACR70 response rates were observed in patients in the rhTNFR:Fc pooled group as compared to MTX used as a monotherapy.

The study findings revealed that in patients with active RA, joint damage inhibition is an attainable goal by combination of MTX and rhTNFR:Fc. Furthermore, the MTX and rhTNFR:Fc combination therapy demonstrated good tolerability.

However, in the future, large-scale prospective cohort study could be performed to explore the impact of maintenance or discontinuation of rhTNFR:Fc during RA treatment on the radiographic progression.