News - Anti-TNF Drugs Cut Mortality Rates among Rheumatoid Arthritis Patients: Presented at ACR

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Anti-TNF Drugs Cut Mortality Rates among Rheumatoid Arthritis

Patients: Presented at ACR

By Bruce Sylvester

SAN DIEGO, CA -- November 18, 2005 -- Anti-TNF therapy and

methotrexate therapy appear to reduce mortality risk in the general

population of patients with rheumatoid arthritis (RA), according to a

study presented here at the American College of Rheumatology Annual

Scientific Meeting (ACR).

Anti-TNF therapy has revolutionized RA treatment in recent years.

Suppression of TNF proteins with infliximab (Remicade), etanercept

(Enbrel) and adalimumab (Humira), and ensuing reductions of joint

inflammation has made these agents widely used as second-line

therapy, after methotrexate.

" We know from prior research that rheumatoid arthritis patients have

higher mortality rates than the general population, " said lead

investigator Kaleb Michaud, MS, Research Fellow, Center for Primary

Care and Outcomes Research, Stanford University Stanford,,

California, and Senior Analyst, National Data Bank for Rheumatic

Diseases, Wichita, Kansas, United States.

" We found a mortality benefit for these newer anti-TNF therapies, " he

said during a press briefing on November 16th.

In the first study to examine the impact of anti-TNF therapy on

mortality rates in RA patients, Mr. Michaud and colleagues studied a

large scale sample of 19,580 patients with RA over a total of 63,811

patient years.

They found that 1129 deaths occurred in the sample population. The

investigators measured these deaths against an index of 13 medical

conditions as well as demographics, disease severity, sex, age, co-

morbidity factors and treatment regimens.

Their results show that prednisone treatment caused an increase in

mortality rates (hazards ratio

---

1.60). However, anti-TNF therapy

(HR 0.72) and methotrexate (HR 0.84) therapy were associated with a

reduction in mortality rates.

Cardiovascular disorders accounted for 33% of deaths, malignancies

for 22% and lung disorders for 19%. MTX, infliximab and etanercept

therapy was most strongly associated with cardiovascular mortality

(HR 0.55 to 0.69) and less strongly associated with pulmonary

disorders (HR 0.75 to 0.76).

" Our findings suggest that patients and doctors should take note that

the use of methotrexate and anti-TNF therapy improves survival [in RA

patients], " he said.

[Presentation title: Reduced Mortality among RA Patients Treated with

Anti-TNF Therapy and Methotrexate. Abstract 296]

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