title: Discontinuation of etanercept in patients with rheumatoid arthritis who were in clinical remission.
abstract: The appearance of tumor necrosis factor blockers changes the treatment goal of rheumatoid arthritis (RA) to include not only the inhibition of bone destruction, but also the induction of remission. We, herein, report two cases with RA that showed a prolonged remission after the discontinuation of etanercept. The two cases were 27 and 38 years of age, and their disease durations were 6 and 14 months, respectively. Their disease activity score 28 (DAS28) before treatment were 4.43 and 5.07, respectively. Case two was resistant to infliximab as determined by previous treatment with this therapy. Both cases showed a dramatic clinical response and discontinued etanercept in the 15th month and the 14th month after the start of treatment, respectively. No exacerbation of arthritis was evident after the discontinuation of etanercept as supported by the maintenance of DAS28 at less than 2.6. Moreover, after the discontinuation of etanercept, radiographic progression was not evident and decreased modified Sharp scores were observed for at least 1 year in both cases. These findings indicate that clinical and radiographic remission is possible in some patients with RA after the discontinuation of etanercept.
authors.affiliation: Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyouhama, Chuou-ku, Fukuoka, 8108563, Japan. miyamura@kyumed.jp
authors.forename: Tomoya
authors.initials: T
authors.lastname: Miyamura
authors.forename: Koshiro
authors.initials: K
authors.lastname: Sonomoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Horai
authors.forename: Soichiro
authors.initials: S
authors.lastname: Takahama
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Rumi
authors.initials: R
authors.lastname: Minami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suematsu
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004334:Drug Administration Schedule; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept