The Pharmaceutical Journal
Vol 269 No 7223 p668
9 November 2002

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American College of Rheumatology (www.rheumatology.org)

Infliximab exerts prolonged response even after the treatment is stopped

Infliximab (Remicade), used to treat rheumatoid arthritis (RA), produces a prolonged therapeutic response even after the drug has been withdrawn, new data show.

Researchers from the University of Leeds randomised 20 patients with early RA to receive infusions of infliximab 3mg/kg or placebo for 12 months in addition to methotrexate with standard dose escalation.

At 54 weeks, the researchers found that more patients treated with infliximab, a tumour necrosis factor alpha (TNFa) inhibitor, showed a 50 per cent improvement in symptoms than those treated with placebo (77 per cent versus 40 per cent, P<0.05).

Although one patient given infliximab was withdrawn from the study after developing vasculitis, all remaining patients have been followed for a mean of 81 weeks, 35 weeks after the study treatment ended. The researchers say that none of the patients who demonstrated a 50 per cent improvement in symptoms after 12 months of infliximab treatment has experienced an increase in disease activity that required additional disease-modifying antirheumatic drugs (DMARDs) or corticosteroid therapy.

Professor Paul Emery, consultant rheumatologist and one of the investigators, said: "The average patient had no clinically detectable disease one year after the infusions were ceased. The results suggest that if infliximab is used early in the disease process it may have a critical long-term effect." He added that until now data had suggested that once started, therapy had to be life long. "This study has shown for the first time a prolonged therapeutic response after withdrawal of infliximab therapy."

The results of the study, which was supported by Schering-Plough, were presented at the American College of Rheumatology annual scientific meeting in New Orleans last month.