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Rheumatoid arthritis

Moving towards IMPROVED drug-free remission

The newly published 5-year outcomes of the IMPROVED trial demonstrate the feasibility of achieving long-term drug-free remission in early rheumatoid arthritis (RA). These findings raise the bar and support the use of a remission induction and maintenance approach, particularly in patients presenting with early joint inflammation consistent with early RA.

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References

  1. Kuijper, T. M., Lamers-Karnebeek, F. B., Jacobs, J. W., Hazes, J. M. & Luime, J. J. Flare rate in patients with rheumatoid arthritis in low disease activity or remission when tapering or stopping synthetic or biologic DMARD: a systematic review. J. Rheumatol. 42, 2012–2022 (2015).

    Article  CAS  Google Scholar 

  2. Akdemir, G. et al. Clinical and radiological outcomes of 5-year drug-free remission-steered treatment in patients with early arthritis: IMPROVED study. Ann. Rheum. Dis. 77, 111–118 (2017).

    Article  Google Scholar 

  3. Heimans, L. et al. A two-step treatment strategy trial in patients with early arthritis aimed at achieving remission: the IMPROVED study. Ann. Rheum. Dis. 73, 1356–1361 (2014).

    Article  CAS  Google Scholar 

  4. Heimans, L. et al. Two-year results of disease activity score (DAS)-remission-steered treatment strategies aiming at drug-free remission in early arthritis patients (the IMPROVED-study). Arthritis Res. Ther. 18, 23 (2016).

    Article  Google Scholar 

  5. Akdemir, G. et al. Predictive factors of radiological progression after 2 years of remission-steered treatment in early arthritis patients: a post hoc analysis of the IMPROVED study. RMD Open 2, e000172 (2016).

    Article  Google Scholar 

  6. Emery, P. et al. Evaluating drug-free remission with abatacept in early rheumatoid arthritis: results from the phase 3b, multicentre, randomised, active-controlled AVERT study of 24 months, with a 12-month, double-blind treatment period. Ann. Rheum. Dis. 74, 19–26 (2015).

    Article  CAS  Google Scholar 

  7. Emery, P. et al. Sustained remission with etanercept tapering in early rheumatoid arthritis. N. Engl. J. Med. 371, 1781–1792 (2014).

    Article  CAS  Google Scholar 

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Acknowledgements

V.P.B. has received grants from the National Institutes of Health, Patient-Centered Outcomes Research Institute and the Canadian Institutes of Health Research.

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Correspondence to Vivian P. Bykerk.

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V.P.B. declares she has acted as an adviser for Amgen, BMS, Pfizer, Sanofi-Genzyme and UCB, and that her institute has received research funding from Amgen, BMS and UCB.

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Supplementary information S1 (box)

The IMPROVED trial 1 year and 2 year outcomes (PDF 86 kb)

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Bykerk, V. Moving towards IMPROVED drug-free remission. Nat Rev Rheumatol 14, 191–192 (2018). https://doi.org/10.1038/nrrheum.2018.49

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