Methotrexate Maintenance After Initiation of Biological or Targeted Synthetic DMARDs in Rheumatoid Arthritis: Results from the 2-Year Longitudinal Prospective Non-interventional STRATEGE2 Study

Le résumé fourni par la source

INTRODUCTION: The primary objective was to describe the therapeutic approach to methotrexate (MTX) use at the initiation of the first biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) in the treatment of rheumatoid arthritis (RA). Secondary objectives included characterising participants initiating b/tsDMARD treatment, examining treatment strategies over time, monitoring disease progression, and identifying factors influencing treatment choices. METHODS: This longitudinal, prospective, non-interventional, multicentre study (STRATEGE2) enrolled adult participants with RA who had been treated with MTX for at least 3 months and required b/tsDMARD treatment due to persistent disease activity. Outcomes were assessed at 12 months (M12) and 24 months (M24) after initiating b/tsDMARD treatment. RESULTS: At baseline, 173 participants with RA had a mean (SD) disease duration of 5.6 (7.3) years and a mean Disease Activity Score in 28 joints (DAS28) score of 4.3 (1.2). Approximately two-thirds had been on MTX for over a year, with a mean weekly dose of 18.8 (4.2) mg (median 20.0), and 72.3% received it subcutaneously. MTX was continued at the initiation of b/tsDMARD therapy in 97.7% of participants. By M12, 83.2% of participants remained on MTX, with 39.9% (95% CI 32.5-47.6) maintaining the same dosage and route of administration. Discontinuation of MTX was primarily due to participant choice or adverse events. At M24, the mean change in DAS28 score was - 2.0 (1.3), with 66.0% of participants achieving remission. On the basis of European Alliance of Associations for Rheumatology (EULAR) classification criteria, 65.2% had a good response, 19.1% a moderate response, and 15.6% an inadequate response. CONCLUSION: The STRATEGE2 study investigators adhered to current clinical guidelines by continuing MTX in combination with b/tsDMARD initiation for the management of RA. TRIAL REGISTRATION: ClinicalTrials.gov: Therapeutic Strategy Associated with bDMARDs or tsDMARDs in Rheumatoid Arthritis and Psoriatic Arthritis (STRATEGE2), NCT05082805.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.