In patients with moderate to severe rheumatoid arthritis (RA) treated with certolizumab pegol (CZP), 12-week clinical response may predict long-term treatment response, according to study results published in Advances in Therapy.

The results indicated that in patients with RA treated with CZP, rapid improvements in clinical, patient-reported, and musculoskeletal ultrasound outcomes were maintained through 52 weeks of follow-up.

The study included participants with moderate to severe RA from CZP-SPEED (ClinicalTrials.gov identifier: NCT01443364) who were biologic-naïve and had not responded to at least 1 disease-modifying antirheumatic drug (DMARD) treatment. 


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Participants received CZP 400 mg at 0, 2, and 4 weeks, then 200 mg every 2 weeks concomitantly with methotrexate. The researchers sought to identify the time point of clinical response (decrease in 28-joint Disease Activity Score [DAS28(ESR)] ≥1.2) that was most predictive of a clinical response at 52 weeks.

Of the 132 participants enrolled, 69% (n=91) completed follow-up through 52 weeks.

The rate of DAS28(ESR) response reached 70% by 4 weeks of treatment, and this rate remained at a similar level through 52 weeks. Participants with a disease duration ≤1 year were less likely to achieve DAS28(ESR) response compared with participants with a longer disease duration.

The results indicated that the predicted 52-week response for early responders (from 2 weeks onward) was between 65% and 70%.

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Participants showed rapid improvements in joint cavity widening and power Doppler signal at 8 weeks, which were maintained through 52 weeks. Cartilage damage and bone erosion were stable over 52 weeks.

“The DAS28(ESR) results demonstrate that there was a ‘predictive window’ between week 4 and week 12, which was the most predictive of a long-term response to treatment,” the researchers wrote.

Reference

Sarzi-Puttini P, Filippucci E, Adami S, et al. Clinical, ultrasound, and predictability outcomes following certolizumab pegol treatment (with methotrexate) in patients with moderate-to-severe rheumatoid arthritis: 52-week results from the CZP-SPEED study. Adv Ther. 2018;35(8):1153-1168. doi:10.1007/s12325-018-0751-8