Friday, 27 Mar 2020

You are here

DRESS Trial Shows TNFi Dose Reduction is Possible - Without Major Flares

Can TNF inhibitor therapy be withdrawn in RA patients who are in remission?  The DRESS trial reports the results of randomized trial of 180 RA patients taking either etanercept or adalimumab. Patients were randomly assigned to either usual care (no dose reduction) or a stepwise increase the injection intervals every three months, until the patients flares has a flare of disease activity or discontinuation.

In those in the reduction group, 20%  reduced the dose, 43% increased the dosing interval and 37% were unable to reduce their dose. The reduction group did have more short-lived flares and possibly more X-ray change.  Hence, disease activity guided, dose reduction strategy of adalimumab or etanercept to was not inferior to usual care with regard to major flaring, while resulting in the successful dose reduction or stopping in two thirds of patients.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Start with Anti-TNF in RA? Not So Fast

The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.

Use of first-line etanercept (Enbrel) plus methotrexate in very early RA was not associated with a substantially higher rate of remission compared with a strategy of treat-to-target methotrexate monotherapy, a randomized open-label trial found.

Best of 2019 - The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Psoriasis Risk Increased with TNF Inhibitors in Juveniles

Children with inflammatory diseases who were treated with tumor necrosis factor (TNF) inhibitors had a higher rate of incident psoriasis than those not exposed to these biologics, a single-center retrospective study found.

The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Pain Persists Despite TNF Inhibitor Use

Control of pain in patients with rheumatoid arthritis (RA) often focuses on control of inflammation as a means to better control pain. However, a new claims data study shows that while anti-tumor necrosis factor inhibitor (TNFi) may lower the use of opioids, the reduction is nominal, suggesting that a substantial amount of pain is not adequately addressed by TNFi - a potent anti-inflammatory approach.