Infliximab Effective in Arthritis Resistant to Methotrexate

Tumor necrosis factor blocker more effective than conventional arthritis drugs

09 aug 2009-- In early rheumatoid arthritis patients who have failed methotrexate treatment, the addition of infliximab is more effective than conventional arthritis drugs, according to a study in the Aug. 8 issue of The Lancet.

Ronald F. van Vollenhoven, M.D., from the Karolinska University Hospital in Stockholm, Sweden, and colleagues randomly assigned 258 patients with early rheumatoid arthritis who had failed methotrexate treatment, but could tolerate the drug, to additional treatment with either sulfasalazine plus hydroxychloroquine or infliximab.

After 12 months, the researchers found that significantly more patients in the infliximab group achieved a good response based on the European League Against Rheumatism criteria (39 versus 25 percent; risk ratio, 1.59). There was one serious adverse event in each group and no deaths. Adverse events were generally balanced between the two groups and were consistent with the known adverse event profiles of the drugs.

"In patients with early rheumatoid arthritis in whom methotrexate treatment failed, addition of a tumor necrosis factor antagonist to methotrexate monotherapy is clinically superior to addition of conventional disease-modifying antirheumatic drugs," van Vollenhoven and colleagues conclude.

The study was supported in part by Schering-Plough.

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