European League Against Rheumatism, June 6-9, 2012Last Updated: June 13, 2012.
The annual meeting of the European League Against Rheumatism was held from June 6 to 9 in Berlin and attracted approximately 14,500 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in rheumatology. The conference highlighted recent advances in the prevention, detection, and treatment of rheumatic diseases of the connective tissue, locomotor, and musculoskeletal systems.
In the AMPLE (Abatacept Versus Adalimumab Comparison in Biologic-Naive Rheumatoid Arthritis Subjects with Background Methotrexate) study, Michael Schiff, M.D., of the University of Colorado in Denver, and colleagues compared the efficacy and safety of two biologics, abatacept and adalimumab, in combination with methotrexate.
"We found that the primary end point of ACR (American College of Rheumatology criteria) 20 showed comparable efficacy for both drugs. AMPLE also found similar results for ACR50 and ACR70 for both drugs. In terms of kinetics of response, we found that both drugs had a quick onset of action and that the kinetics of both drugs were similar," Schiff said.
In terms of radiologic inhibition, the investigators found that 85 to 88 percent of patients had no progression on X-rays. In addition, both drugs showed similar adverse events. However, abatacept was associated with slightly less discontinuation and no injection site reactions leading to discontinuation, while adalimumab was associated with three withdrawals due to injection site reactions.
"Overall, we found that abatacept (T-cell inhibitor) was equally as effective as adalimumab (anti- tumor necrosis factor-[TNF] agent) in combination with methotrexate for the treatment of rheumatoid arthritis, with a similar if not slightly better adverse event profile," Schiff added.
In another study, Philip Mease, M.D., of the University of Washington in Seattle, and colleagues randomized patients with psoriatic arthritis to certolizumab 200 mg every two weeks, certolizumab 400 mg every four weeks, or placebo.
The results showed that the primary end point of ACR20 at 12 weeks was met, with 58 percent of patients in the 200-mg group having an ACR20 response, compared to 24 percent in the placebo group," Mease said.
The investigators found similar results when the 400-mg group was compared to placebo. In terms of kinetics of response, the investigators found that certolizumab separated from placebo within the first week of treatment, demonstrating a fast onset of action.
"It is important to note that these results were achieved despite the fact that 20 percent of the patients had lost response to TNF inhibitor therapy previously," Mease added. "Overall, certolizumab is an effective option for the treatment of psoriatic arthritis, has a rapid onset of action, and demonstrated effectiveness in patients who had previously lost response or stopped treatment with another anti-TNF agent. Certolizumab is an important new addition to the treatment algorithm for psoriatic arthritis."
Ozlem Pala, M.D., of the University of Miami Miller School of Medicine, and colleagues found that smoking reduced the response to anti-TNF therapies in patients with rheumatoid arthritis. The investigators evaluated 2,811 treatment-naive patients starting anti-TNF therapy, including 19 percent who were smokers and 81 percent who were nonsmokers.
"There have been several studies which have investigated factors affecting response to anti-TNFs, but this is the first study to investigate response factors in such a large cohort of people. Being able to better predict response rates to treatment means that rheumatologists can discuss the findings with their patients who smoke and strongly encourage them to quit," Pala said in a statement. "This may also motivate them to develop successful strategies for smoking cessation in order to maximize effect of this expensive group of medications and potentially increase quality of life for these patients."
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