Treatment with etanercept and methotrexate for rheumatoid arthritis can be safely tapered, says study

A new study suggests that people with rheumatoid arthritis who responds positively to treatment with an etanercept and methotrexate-based therapeutic regimen may be able to reduce or even stop taking the drugs without seeing a negative impact on their overall outcome.

The study, led by Wroclaw Medical University in Poland, and published in the Journal of Rheumatology, aimed to assess the effects of treatment reduction and withdrawal on patient-reported outcomes in individuals with early moderate-to-severe rheumatoid arthritis who had seen an encouraging response to etanercept/methotrexate therapy.

A total of 306 people received a 50 mg dose of etanercept plus methotrexate for 52 weeks for this study. Those participants who achieved low disease activity after this time were either switched to a reduced 25 mg etanercept dose or placebo for 39 weeks and if they were then able to achieve remission on the reduced dose, they had all treatment withdrawn and were observed for an additional 26 weeks.

Of the 306 participants, 193 were randomised to receive either the reduced dose or placebo, while 131 participated in the treatment-withdrawal phase. Presenteeism and activity impairment scores were significantly better in the etanercept reduced-dose group versus methotrexate monotherapy and placebo at 39 weeks.

The researchers concluded: “In patients with early rheumatoid arthritis who achieved remission while receiving full-dose etanercept/methotrexate, continuing combination therapy at a lower dose did not cause a significant worsening of patient-reported outcomes.”

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