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Abstract
Objectives: To evaluate the efficacy and safety of adalimumab (ADA) and methotrexate (MTX) in patients with rheumatoid arthritis (RA) and investigate critical factors associated with efficacy.
Methods: In this retrospective cohort study, patients received ADA at a single facility. Clinical outcome was retrospectively evaluated using the Disease Activity Score in 28 joints with Erythrocyte Sedimentation Rate (DAS28-ESR).
Results: Of the 122 patients undergoing treatment with ADA between July 2008 and April 2014, DAS28-ESR data after 6 months of treatment were available for 103 and 87 (84.5%) were treated with a combination of ADA and MTX. For combination therapy, time lag between MTX and the initiation of ADA significantly correlated with efficacy of ADA at 6 months, as well as prior use of biologics, but not disease duration.
Conclusions: Clinical outcomes were correlated with the time lag between MTX and the initiation of ADA, not disease duration. Early initiation of ADA after MTX might improve clinical outcomes.
Acknowledgements
We thank Ms. Harumi Kondo and Ms. Mayumi Ota for their support and collection of clinical data and Mr. Nicholas Crabb and Dr. Guy Harris for their editing of the manuscript.
Conflict of interest
NK has no conflicts of interest to declare. KS has received a research grant from Eisai and Bristol-Myers K.K. TT has received grants from Abbott Japan, AbbVie GK, Asahikasei Pharma, Astellas Pharma, Bristol-Myers K.K., Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma, Pfizer Japan, Sanofi-Aventis K.K., Santen Pharmaceutical, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical, and Teijin Pharma; speaking fees from Abbott Japan, Astellas Pharma, Bristol-Myers K.K., Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma, Pfizer Japan, and Takeda Pharmaceutical; and consultant fees from AbbVie GK, Asahi Kasei Medical K.K., Astra Zeneca K.K., Daiichi Sankyo, Eli Lilly Japan K.K., Novartis Pharma K.K., and Mitsubishi Tanabe Pharma.
This work is partially supported by a Grant-in-Aid for Scientific Research.