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Immediate TNFi treatment may become an efficient treatment option in early RA, due to its long-term advantages in terms of efficacy and promise of offering disease reversal and sustained remission for RA patients.
The first-line tumor necrosis factor inhibitors (TNFis) show notable improvements over one year among individuals with MTX-naïve RA, as per the findings of a Systematic Literature Review and Meta-Analysis published in the Journal of Advances in Therapy.
Previous Cochrane Central Register of Controlled Trials, PubMed, and systematic
reviews were examined for randomized controlled trials (RCTs) which contain
data regarding management of methotrexate-naïve RA persons using the first-line
TNFis. Literature was incorporated qualitatively, and a meta-analysis directed
to assess clinical remission, Health Assessment Questionnaire Disability Index
(HAQ), and American College of Rheumatology (ACR) responses at Years 2 and/or
5.
A total of 10 RCTs comprising 4306 patients were selected.
Seven studies were entirely or partly open-label, and the other three studies
were double-blind (for two years). Five studies (all were open-label) described
data at Year 5. Further, Not open-label but double-blind RCTs showed
considerably improved ACR70 response, ACR50 response, and remission rates with
first-line TNFi treatment at Year 2. The between-group differences in mean HAQ
at Year 2 were also negligible in open-label or double-blind RCTs or ACR
response or remission outcomes at Year 5.
This was the first type of analysis that gives evidence
regarding TNFs efficacy over one year in MTX-naive early RA patients. However,
more investigation is required to assess the efficiency of TNFi therapy
over ≥ 2 years among individuals with methotrexate-naïve RA.
Advances in Therapy
Long-Term Efficacy of Tumor Necrosis Factor Inhibitors for the Treatment of Methotrexate-Naïve Rheumatoid Arthritis: Systematic Literature Review and Meta-Analysis
La´szlo´ Gula´csi et al.
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