VIENNA — Response rates to biologic agents are high among patients with rheumatoid arthritis, but remission rates remain disappointingly low, Mikkel Ostergaard, M.D., said at the annual European congress of rheumatology.
According to the Danish Database for Biological Therapies in Rheumatology (DANBIO), two-thirds of patients on tumor necrosis factor-α blockers have persistently inadequate inflammatory control.
A total of 417 patients in Denmark receiving these drugs have been enrolled in DANBIO since October 2000—378 on infliximab and 39 on etanercept. Disease activity was measured at baseline and six times during the following year.
At baseline, the median disease duration was 9 years, swollen joint count was 10, tender joint count was 11, serum C-reactive protein was 27 mcg/mL, and DAS-28 was 5.9.
The median number of disease-modifying antirheumatic drugs taken previously was four.
There were no differences in baseline data or clinical response between patients receiving infliximab and those receiving etanercept.
From week 6 on, 15%–20% of patients were in clinical remission and another 10%–15% had low disease activity. Thus, approximately 70% of patients had moderate or high disease activity, said Dr. Ostergaard of Copenhagen University Hospitals.
Despite this less than optimal response in many patients, the median time they remained on the same drug exceeded 2 years, he said at the congress, sponsored by the European League Against Rheumatism.
This illustrates that continuous close monitoring of each patient with careful consideration of therapeutic adjustments is needed in daily clinical practice to achieve the goal of disease control in RA patients treated with biologics, he said.
Dr. Ostergaard disclosed that he has received financial support from Schering-Plough and Wyeth Pharmaceuticals.