Meta-analysis suggests that intensive non-biological combination therapy with step-down prednisolone (COBRA strategy) may also 'disconnect' disease activity and damage in rheumatoid arthritis

Annals of the Rheumatic Diseases

Volumn 72, Issue 3, 2013, Pages 406-409

  Boers, Maarten ^a   Van Tuyl, Lilian ^a   Van Den Broek, Marianne ^b   Kostense, Piet J ^a   Allaart, Cornelia F ^b  

^a VU UNIVERSITY MEDICAL CENTER   (Netherlands)

^b LEIDEN UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

[No Author keywords available]

Indexed keywords

C REACTIVE PROTEIN; GLUCOCORTICOID; INFLIXIMAB; METHOTREXATE; PREDNISOLONE; SALAZOSULFAPYRIDINE; TUMOR NECROSIS FACTOR; TUMOR NECROSIS FACTOR INHIBITOR;

ARTICLE; CLINICAL TRIAL; DISEASE ACTIVITY; DISEASE COURSE; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG MEGADOSE; HUMAN; INDEPENDENT VARIABLE; MAJOR CLINICAL STUDY; META ANALYSIS; MONOTHERAPY; PRIORITY JOURNAL; REMISSION; RHEUMATOID ARTHRITIS; SCORING SYSTEM;

ANTIRHEUMATIC AGENTS; ARTHRITIS, RHEUMATOID; DISEASE PROGRESSION; DRUG THERAPY, COMBINATION; HUMANS; JOINTS; METHOTREXATE; PREDNISOLONE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SULFASALAZINE;

EID: 84873703024     PISSN: 00034967     EISSN: 14682060     Source Type: Journal    
DOI: 10.1136/annrheumdis-2012-202333     Document Type: Article

References (15)

1. Van Leeuwen MA, van Rijswijk MH, Sluiter WJ, et al. Individual relationship between progression of radiological damage and the acute phase response in early rheumatoid arthritis. Towards development of a decision support system. J Rheumatol 1997;24:20-7.
2. Smolen JS, Han C, Bala M, et al. Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study. Arthritis Rheum 2005;52:1020-30.
3. Landewe R, van der Heijde D, Klareskog L, et al. Disconnect between inflammation and joint destruction after treatment with etanercept plus methotrexate: results from the trial of etanercept and methotrexate with radiographic and patient outcomes. Arthritis Rheum 2006;54:3119-25.
4. Landewe R, Keystone E, Smolen J, et al. Disconnect between disease activity and joint space narrowing for patients with early ra treated with adalimumab plus methotrexate but not methotrexate alone: case for anti-TNF cartilage protection. J Rheumatol 2011;38:1156.
5. Emery P, Genovese MC, van Vollenhoven R, et al. Less radiographic progression with adalimumab plus methotrexate versus methotrexate monotherapy across the spectrum of clinical response in early rheumatoid arthritis. J Rheumatol 2009;36:1429-41.
6. Smolen JS, Avila JCM, Aletaha D. Tocilizumab inhibits progression of joint damage in rheumatoid arthritis irrespective of its anti-inflammatory effects: disassociation of the link between inflammation and destruction. Ann Rheum Dis 2012;71:687-93.
7. Boers M. Demonstration of response in rheumatoid arthritis patients who are nonresponders according to the American College of Rheumatology 20% criteria: the paradox of beneficial treatment effects in nonresponders in the ATTRACT trial. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy. Arthritis Rheum 2001;44:2703-4.
8. Boers M, Verhoeven AC, Markusse HM, et al. Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis [see comments) (published erratum appears in Lancet 1998 Jan 17;351(9097):220]. Lancet 1997;350:309-18.
9. Grigor C, Capell H, Stirling A, et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 2004;364:263-9.
10. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, et al. Comparison of treatment strategies in early rheumatoid arthritis: a randomized trial. Ann Intern Med 2007;146:406-15.
11. Svensson B, Boonen A, Albertsson K, et al. Low-dose prednisolone in addition to the initial disease-modifying antirheumatic drug in patients with early active rheumatoid arthritis reduces joint destruction and increases the remission rate: a two-year randomized trial. Arthritis Rheum 2005;52:3360-70.
12. Möttönen T, Hannonen P, Leirisalo-Repo M, et al. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomised trial. Lancet 1999;353:1568-73.
13. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum 2005;52:3381-90.
14. Landewe RB, Boers M, Verhoeven AC, et al. COBRA combination therapy in patients with early rheumatoid arthritis: Long-term structural benefits of a brief intervention. Arthritis Rheum 2002;46:347-56.
15. van Tuyl LH, Boers M, Lems WF, et al. Survival, comorbidities and joint damage 11 years after the COBRA combination therapy trial in early rheumatoid arthritis. Ann Rheum Dis 2010;69:807-12.