title: Benefits 8 years after a remission induction regime with an infliximab and methotrexate combination in early rheumatoid arthritis.
abstract: OBJECTIVE
  To ascertain whether a 1-year remission induction therapy with an infliximab-MTX (INF-MTX) combination in patients with early RA provided sustained benefit after INF cessation compared with conventional treatment.
  
  
  METHODS
  Twenty patients with poor prognosis RA of < 1 year of disease duration were randomized to receive either INF and MTX or placebo infusions and MTX for 1 year. They then stepped down to MTX monotherapy and were treated according to standard clinical care. After 8 years, disease activity, function and quality of life (QoL) data were collected.
  
  
  RESULTS
  At follow-up, data were available for 18 patients (1 in each group had died). Median 28-joint DAS was significantly lower in the INF-MTX group compared with placebo-MTX group (2.7 vs 4.3, P = 0.02). Four patients in the INF-MTX group were in remission vs none in the placebo-MTX group. One patient in the INF-MTX group achieved drug-free remission. Both RAQoL and HAQ median scores were lower in the INF-MTX group; however, this did not reach statistical significance (median RAQoL 3 vs 8, P = 0.18; median HAQ 1.0 vs 1.5, P = 0.12).
  
  
  CONCLUSIONS
  A remission induction regime with an INF-MTX combination for 1 year in early RA can improve long-term clinical outcomes. Larger studies will be required to confirm the implications of these findings.
authors.affiliation: Academic Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds Leeds, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Bejarano
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
authors.forename: Mark A
authors.initials: MA
authors.lastname: Quinn
authors.forename: Benazir
authors.initials: B
authors.lastname: Saleem
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D008727:Methotrexate