Featured Research

from universities, journals, and other organizations

Decreasing medication does not equal more risks for people with rheumatoid arthritis in remission

Date:
November 11, 2012
Source:
American College of Rheumatology (ACR)
Summary:
Extending the time between doses, or tapering, TNF-inhibitor drugs in people with rheumatoid arthritis in remission can be done in some patients without significantly increasing disease activity or impairing joint function, according to new research findings.

Extending the time between doses, or tapering, TNF-inhibitor drugs in people with rheumatoid arthritis in remission can be done in some patients without significantly increasing disease activity or impairing joint function, according to new research findings presented this week at the American College of Rheumatology Annual Meeting in Washington, D.C.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.

Once people with RA achieve remission, doctors often try to increase the interval between doses of drugs, which is called tapering, but doing so involves the risk of increasing disease activity and joint damage, reducing physical function, or causing a relapse. Researchers in France looked into how increasing the interval between injections of TNF-inhibitor drugs, which are both costly and may sometimes have serious side effects, might affect patients. They conducted an 18-month randomized, controlled trial involving 137 people with RA treated with biologic agents that inhibit TNF, who were in stable remission for at least six months. Seventy-eight percent of the participants were female, and all were using either etanercept (Enbrel®) or adalimumab (Humira®), for one year either alone or in combination with other drugs. Participants could be taking five milligrams or less of the corticosteroid drug prednisone daily.

Researchers split the participants into two randomized groups: One set using a progressive spacing out of injections of their TNF-inhibitor and one set who continued taking their injections at full doses at the approved time intervals. In the first group, doctors increased the time between two injections by 50 percent every three months up to a complete stop by the fourth interval. If the participants RA disease activity or physical function worsened, the patient stopped tapering doses of the drugs and was moved back to previous dose. To test the patient's disease activity, function level and signs of relapse, doctors used standard scoring methods and health assessment questionnaires.

After 18 months, the researchers found that 82 percent of the RA participants were able to space out or stop their TNF-inhibitor injections without significant increases in either disease activity or functional impairment. However, the study did not demonstrate that the spacing approach was statistically equivalent to the traditional regimen. They also found that relapses occurred more frequently in the group that spaced injections compared to those who stayed on the same dosing schedule; but overall this did not result in differences in disease activity between the groups. The researchers are still analyzing X-rays to determine if the spacing strategy caused structural damage to their joints.

"A lot of effort has been dedicated to the development of new treatments for RA, leading to a substantial increase in RA costs. Nowadays, remission is achievable and treatment tapering needs to be considered and assessed," says Bruno Fautrel, MD, PhD, lead investigator in the study and professor at the University of Paris Medical Center in France. "RA is a chronic disease and the risk-benefit balance of taking DMARDs to manage the condition should be explored. Issues that should be evaluated include the risk of tapering or stopping DMARDs given that reducing medication may lead to flares and potential structural damage. Additional issues that should be considered are drug toxicity from continued DMARD use and substantial economic burden to society. This study explored the balance and tested the feasibility of biologic DMARD tapering (i.e., either interruption of current treatment or identification of the minimal effective dose)."

Funding for this study was provided by French Ministry of Health. The study was also promoted by the Assistance Publique -- Hôpitaux de Paris.


Story Source:

The above story is based on materials provided by American College of Rheumatology (ACR). Note: Materials may be edited for content and length.


Cite This Page:

American College of Rheumatology (ACR). "Decreasing medication does not equal more risks for people with rheumatoid arthritis in remission." ScienceDaily. ScienceDaily, 11 November 2012. <www.sciencedaily.com/releases/2012/11/121111153610.htm>.
American College of Rheumatology (ACR). (2012, November 11). Decreasing medication does not equal more risks for people with rheumatoid arthritis in remission. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2012/11/121111153610.htm
American College of Rheumatology (ACR). "Decreasing medication does not equal more risks for people with rheumatoid arthritis in remission." ScienceDaily. www.sciencedaily.com/releases/2012/11/121111153610.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) — The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) — An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) — Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
CDC Calls for New Ebola Safety Guidelines

CDC Calls for New Ebola Safety Guidelines

AP (Oct. 20, 2014) — Centers for Disease Control and Prevention Director Dr. Tom Frieden laid out new guidelines for health care workers when dealing with the deadly Ebola virus including new precautions when taking off personal protective equipment. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins