The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib
Abstract Introduction While modern treatments can prevent progressive bone destruction in patients with rheumatoid arthritis (RA) achieving clinical remission, it is unclear whether residual clinical activity may cause or be associated with progressive joint damage. This post hoc analysis evaluated...
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Adis, Springer Healthcare
2024-11-01
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| Series: | Rheumatology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40744-024-00725-7 |
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| author | Yoshiya Tanaka Tatsuya Atsumi Daniel Aletaha Hendrik Schulze-Koops Haruhiko Fukada Chris Watson Tsutomu Takeuchi |
| author_facet | Yoshiya Tanaka Tatsuya Atsumi Daniel Aletaha Hendrik Schulze-Koops Haruhiko Fukada Chris Watson Tsutomu Takeuchi |
| author_sort | Yoshiya Tanaka |
| collection | DOAJ |
| description | Abstract Introduction While modern treatments can prevent progressive bone destruction in patients with rheumatoid arthritis (RA) achieving clinical remission, it is unclear whether residual clinical activity may cause or be associated with progressive joint damage. This post hoc analysis evaluated the association between clinical disease activity and structural progression in patients with RA treated with filgotinib (FIL) in FINCH 1 (NCT02889796). Methods Patients with RA and inadequate response to methotrexate (MTX) use were randomized 3:3:2:3 to FIL 200 mg (FIL200) or FIL 100 mg (FIL100) once daily, adalimumab 40 mg biweekly, or placebo, all with background MTX. We evaluated the change from baseline (CFB) in modified total Sharp score (mTSS), erosion score, and joint space narrowing score among patients achieving Clinical Disease Activity Index (CDAI) remission (CDAI ≤ 2.8), low disease activity (LDA; 2.8 < CDAI ≤ 10), medium disease activity (MDA; 10 < CDAI ≤ 22), and high disease activity (HDA; CDAI > 22) at 24 weeks. Results At week 24, the least squares (LS) mean CFB in mTSS was similarly low across treatments among patients who achieved CDAI remission (range 0.00–0.11) or LDA (n = 285 and 575, respectively). In patients with MDA and HDA (n = 471 and 157, respectively), smaller LS mean CFB in mTSS was seen in the FIL200 group vs. the placebo group (P < 0.05 for both). Conclusions RA clinical remission and LDA achievement were associated with suppressed progression of joint destruction over 24 weeks in all treatment groups. Only FIL200 significantly inhibited joint damage compared with placebo in patients with MDA or HDA, indicating an uncoupling of clinical disease activity and structural progression in patients receiving FIL200. Trial Registration NCT02889796. |
| format | Article |
| id | doaj-art-cb314c5e016943d38c06efb328ef3466 |
| institution | Kabale University |
| issn | 2198-6576 2198-6584 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Adis, Springer Healthcare |
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| series | Rheumatology and Therapy |
| spelling | doaj-art-cb314c5e016943d38c06efb328ef34662025-01-26T12:52:09ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842024-11-01121536610.1007/s40744-024-00725-7The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with FilgotinibYoshiya Tanaka0Tatsuya Atsumi1Daniel Aletaha2Hendrik Schulze-Koops3Haruhiko Fukada4Chris Watson5Tsutomu Takeuchi6First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health JapanDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido UniversityDivision of Rheumatology, Department of Medicine, Medical University of ViennaDivision of Rheumatology and Clinical Immunology, Department of Medicine IV, Ludwig Maximilian UniversityGilead Sciences K.K.Galapagos NVDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineAbstract Introduction While modern treatments can prevent progressive bone destruction in patients with rheumatoid arthritis (RA) achieving clinical remission, it is unclear whether residual clinical activity may cause or be associated with progressive joint damage. This post hoc analysis evaluated the association between clinical disease activity and structural progression in patients with RA treated with filgotinib (FIL) in FINCH 1 (NCT02889796). Methods Patients with RA and inadequate response to methotrexate (MTX) use were randomized 3:3:2:3 to FIL 200 mg (FIL200) or FIL 100 mg (FIL100) once daily, adalimumab 40 mg biweekly, or placebo, all with background MTX. We evaluated the change from baseline (CFB) in modified total Sharp score (mTSS), erosion score, and joint space narrowing score among patients achieving Clinical Disease Activity Index (CDAI) remission (CDAI ≤ 2.8), low disease activity (LDA; 2.8 < CDAI ≤ 10), medium disease activity (MDA; 10 < CDAI ≤ 22), and high disease activity (HDA; CDAI > 22) at 24 weeks. Results At week 24, the least squares (LS) mean CFB in mTSS was similarly low across treatments among patients who achieved CDAI remission (range 0.00–0.11) or LDA (n = 285 and 575, respectively). In patients with MDA and HDA (n = 471 and 157, respectively), smaller LS mean CFB in mTSS was seen in the FIL200 group vs. the placebo group (P < 0.05 for both). Conclusions RA clinical remission and LDA achievement were associated with suppressed progression of joint destruction over 24 weeks in all treatment groups. Only FIL200 significantly inhibited joint damage compared with placebo in patients with MDA or HDA, indicating an uncoupling of clinical disease activity and structural progression in patients receiving FIL200. Trial Registration NCT02889796.https://doi.org/10.1007/s40744-024-00725-7Clinical remissionDisease activityFilgotinibMethotrexateRheumatoid arthritisStructural progression |
| spellingShingle | Yoshiya Tanaka Tatsuya Atsumi Daniel Aletaha Hendrik Schulze-Koops Haruhiko Fukada Chris Watson Tsutomu Takeuchi The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib Rheumatology and Therapy Clinical remission Disease activity Filgotinib Methotrexate Rheumatoid arthritis Structural progression |
| title | The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib |
| title_full | The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib |
| title_fullStr | The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib |
| title_full_unstemmed | The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib |
| title_short | The Uncoupling of Disease Activity from Joint Structural Progression in Patients with Rheumatoid Arthritis Treated with Filgotinib |
| title_sort | uncoupling of disease activity from joint structural progression in patients with rheumatoid arthritis treated with filgotinib |
| topic | Clinical remission Disease activity Filgotinib Methotrexate Rheumatoid arthritis Structural progression |
| url | https://doi.org/10.1007/s40744-024-00725-7 |
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