Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan: one-year clinical outcomes (RECONFIRM-2) |
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Authors: | Yoshiya Tanaka Tsutomu Takeuchi Eisuke Inoue Kazuyoshi Saito Naoya Sekiguchi Eri Sato Masao Nawata Hideto Kameda Shigeru Iwata Kouichi Amano Hisashi Yamanaka |
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Institution: | (1) The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi Kitakyushu, 807-8555, Japan;(2) Division of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan;(3) Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan |
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Abstract: | Biologics targeting TNF have brought about a paradigm shift in the treatment of rheumatoid arthritis (RA) and infliximab,
anti-TNF-α chimeric monoclonal antibody, was marketed in 2003 in Japan. We previously reported on the RECONFIRM study, a retrospective
clinical study on the efficacy of infliximab therapy in a RA management group in Japan, where we evaluated the clinical response
after 22 weeks of the therapy in 258 patients. The study reported here was aimed at reconfirming the clinical efficacy of
the infliximab therapy and demographic factors related to the efficacy over a 54-week study period in 410 RA patients in the
same study group. Infliximab was infused according to the domestically approved method, and the clinical response was evaluated
following 54 weeks of infliximab therapy using the European League Against Rheumatism (EULAR) response criteria. Disease activity
was assessed by DAS28-CRP (Disease Activity Score including a 28-joint count/C-reactive protein). Infliximab was discontinued
in 24.4% of the 410 patients at 54 weeks and 9.3% and 8.1% discontinued the therapy due to adverse events and inefficiency,
respectively. Average DAS28-CRP decreased from 5.5 at week 0 to 3.1 at week 54 after the therapy. Patients in remission and
those showing low-, moderate-, and high-disease activity changed from 0.0, 1.0, 9.0 and 90.0%, respectively, at the start
of the study to 27.6, 11.7, 34.4 and 26.3%, respectively, at week 54. Younger age, RF-negativity and low scores of DAS28-CRP
showed significant correlations with remission at week 54. EULAR response criteria—good, moderate, and no response to infliximab—were
37.0, 41.7 and 21.2%, respectively. In conclusion, we reconfirmed the clinical efficacy of infliximab and demographic factors
related to the efficacy over a 54-week study period in 410 Japanese patients with RA using DAS28-CRP and EULAR response criteria. |
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Keywords: | Rheumatoid arthritis Infliximab EULAR response Retrospective study |
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