Impact of methotrexate dose on efficacy of adalimumab in Japanese patients with rheumatoid arthritis: Results from registered data analyses

Yasuharu Nakashima, Hisaaki Miyahara, Masakazu Kondo, Takaaki Fukuda, Hiroshi Harada, Akihisa Haraguchi, Yasushi Inoue, Takashi Ishinishi, Masayuki Maekawa, Akira Maeyama, Munetoshi Nakashima, Eisuke Shono, Eiichi Suematsu, Takashi Shimauchi, Tomomi Tsuru, Hiroshi Tsukamoto, Shigeru Yoshizawa, Seiji Yoshizawa, Yukihide Iwamoto

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objective: Upper limit of methotrexate (MTX) for patients with rheumatoid arthritis (RA) was recently increased from 8 to 16 mg/week in Japan. We therefore examined the effect of concomitant MTX dose on the efficacy of adalimumab (ADA) in clinical practice. Method: Sixty-one consecutive RA patients treated with ADA were followed for minimum 52 weeks and retrospectively compared by MTX dose; patients receiving concomitant MTX of 10 mg/week or more (MTX ≥10 mg group) and <10 mg/week (MTX <10 mg group). Disease activity and remission were evaluated by the disease activity score 28 (DAS28) criteria. Results: The MTX ≥10 mg group consistently showed better improvement in DAS28 and resulted in more patients (52.8%) with DAS28-remission compared with the MTX <10 mg group (26.1%). Multivariate analysis showed that MTX ≥10 mg had a significant effect on DAS28 remission with odds ratio of 5.12. ADA retention rate was 72.2% in MTX ≥10 mg group compared with 52.0% in MTX <10 mg group. Discontinuation of ADA due to adverse events were comparable in the MTX ≥10 mg and MTX <10 mg groups (11.1% vs. 12.0%). Conclusions: These findings support the critical role of concomitant MTX in the efficacy of ADA, and recommend use of MTX ≥10 mg in Japanese RA patients.

Original languageEnglish
Pages (from-to)15-21
Number of pages7
JournalModern Rheumatology
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 2 2017

All Science Journal Classification (ASJC) codes

  • Rheumatology

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