title: Can the association of Ciclosporine A and Methotrexate maintain remission/low disease activity induced by etanercept in early Rheumatoid Arthritis patients? Evaluation by Magnetic Resonance Imaging.
abstract: The opportunity to induce remission/low disease activity in Rheumatoid Arthritis (RA) patients has been achieved in recent years by the adoption of more sensitive diagnostic methods &#x005B;Magnetic Resonance Imaging (MRI), ultrasonography&#x005D; and early aggressive treatments (combination of biologics and synthetic DMARDs). On the other hand, data are still scarce and contrasting about the management of long-term remission. The aim of this preliminary study is to evaluate whether the association of Methotrexate + Ciclosporine A (MTX + CSA) therapy in early RA (eRA) patients is able to maintain remission/low  disease  activity and avoid structural progression, evaluated by MRI.  Etanercept was suspended in patients who reached remission/low disease activity and CSA+MTX therapy was introduced (T0), all patients  continued to receive MTX; at this time  MRI showed mild/moderate synovitis and erosions in all the patients; 1-year after (T1), a slight reduction in mean synovitis, bone edema and total score was observed, whereas the erosion score was unchanged. The mean DAS44 remained stable from T0 to T1 and 6/7 patients maintained a low disease activity score. No side effects were reported. These results confirm the good clinical efficacy and safety of the combination therapy CSA+MTX in eRA patients and demonstrate a parallel arrest of structural damage evaluated by MRI 1-year after etanercept suspension.
authors.forename: A
authors.initials: A
authors.lastname: Picchianti Diamanti
authors.forename: G
authors.initials: G
authors.lastname: Argento
authors.forename: E
authors.initials: E
authors.lastname: Podestà
authors.forename: V
authors.initials: V
authors.lastname: Germano
authors.forename: S
authors.initials: S
authors.lastname: Fazi
authors.forename: A
authors.initials: A
authors.lastname: Migliore
authors.forename: V
authors.initials: V
authors.lastname: David
authors.forename: R
authors.initials: R
authors.lastname: D'Amelio
authors.forename: B
authors.initials: B
authors.lastname: Laganà
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D016572:Cyclosporine; D000068800:Etanercept; D008727:Methotrexate