TY - JOUR T1 - Achieving comprehensive disease control in patients with early and established rheumatoid arthritis treated with adalimumab plus methotrexate versus methotrexate alone JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2017-000445 VL - 3 IS - 2 SP - e000445 AU - Edward C Keystone AU - Ferdinand C Breedveld AU - Désirée van der Heijde AU - Ronald F van Vollenhoven AU - Paul Emery AU - Josef S Smolen AU - Iain Sainsbury AU - Stefan Florentinus AU - Hartmut Kupper AU - Kun Chen AU - Arthur Kavanaugh Y1 - 2017/09/01 UR - http://rmdopen.bmj.com/content/3/2/e000445.abstract N2 - Objective To evaluate the achievement of comprehensive disease control (CDC) following 1 year of treatment with adalimumab+methotrexate versus methotrexate alone and whether early achievement of remission (at week 24 or 26) is associated with CDC at week 52 in patients with either early or established rheumatoid arthritis (RA).Methods Post hoc analyses were conducted in three clinical studies assessing treatment with adalimumab+methotrexate: DE019 (NCT00195702) enrolled patients with established RA who were methotrexate inadequate responders; OPTIMA (NCT00420927) and PREMIER (NCT00195663) enrolled methotrexate-naive patients with early RA. In OPTIMA, patients not achieving stable low disease activity at weeks 22 and 26 in the placebo+methotrexate group could receive open-label adalimumab+methotrexate for 52 weeks (Rescue ADA arm). CDC was defined as the simultaneous achievement of clinical remission (DAS28(CRP)<2.6), normal function (HAQ-DI<0.5) and absence of radiographic progression (ΔmTSS≤0.5).Results Regardless of disease duration, significantly more patients receiving adalimumab+methotrexate achieved CDC compared with methotrexate alone. In the adalimumab+methotrexate group, a numerically greater proportion of patients with early RA (~25%) versus established RA (14%) achieved CDC at 1 year; achievement of CDC was notably greater among patients who met criteria for remission at week 24 or 26 (~50% of patients with early RA and 39% with established RA).Conclusion Treatment with adalimumab+methotrexate increases the likelihood of achieving CDC in patients with either early or established RA. Clinical remission at week 24 or 26 is associated with achievement of CDC at week 52.Trial registration number DE019 (NCT00195702), OPTIMA (NCT00420927), PREMIER (NCT00195663); Post-results. ER -