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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\n      \u003Ch2\u003ESummary\u003C\/h2\u003E\n      \u003Cp id=\u0022p-1\u0022\u003EData from the Randomized, Double-Blind Study Comparing the Safety \u0026amp; Efficacy of Once-Weekly Etanercept 50 mg, Etanercept 25 mg, \u0026amp; Placebo in Combination With Methotrexate in Subjects With Active Rheumatoid Arthritis [PRESERVE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00565409\u0026amp;atom=%2Fspmdc%2F11%2F13%2F18.atom\u0022\u003ENCT00565409\u003C\/a\u003E] show that patients with moderately active rheumatoid arthritis (RA) achieve and maintain low disease activity and remission with anti-tumor necrosis factor therapy more successfully than those with high RA activity [Keystone E et al. \u003Cem\u003EJ Rheumatol\u003C\/em\u003E 2009].\u003C\/p\u003E\n   \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Erheumatoid arthritis clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n      \u003Cp id=\u0022p-2\u0022\u003EReimbursement and safety concerns have spurred growing interest in strategies that involve treatment dose reduction or discontinuation once subjects achieve adequate response.\u003C\/p\u003E\n      \u003Cp id=\u0022p-3\u0022\u003EData from the Randomized, Double-Blind Study Comparing the Safety \u0026amp; Efficacy of Once-Weekly Etanercept 50 mg, Etanercept 25 mg, \u0026amp; Placebo in Combination With Methotrexate in Subjects With Active Rheumatoid Arthritis [PRESERVE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00565409\u0026amp;atom=%2Fspmdc%2F11%2F13%2F18.atom\u0022\u003ENCT00565409\u003C\/a\u003E] show that patients with moderately active rheumatoid arthritis (RA) achieve and maintain low disease activity and remission with anti-tumor necrosis factor (anti-TNF) therapy more successfully than those with high RA activity [Keystone E et al. \u003Cem\u003EJ Rheumatol\u003C\/em\u003E 2009].\u003C\/p\u003E\n      \u003Cp id=\u0022p-4\u0022\u003EThe PRESERVE trial compared the efficacy and safety of continuing etanercept 50 mg once weekly+methotrexate 50 mg (E50\/M), reducing etanercept from 50 mg to 25 mg once weekly+methotrexate 25 mg (E25\/M), then withdrawing etanercept and giving placebo once weekly +methotrexate (P\/M) over 52 weeks after sustained low disease activity had been induced during 9 months of E50\/M treatment. The primary outcome of the randomized double-blind trial was Disease Activity Score (DAS28) over 88 weeks.\u003C\/p\u003E\n      \u003Cp id=\u0022p-5\u0022\u003EParticipants were 18 to 70 years of age, with a diagnosis of RA who were currently receiving an optimal dose of oral MTX (at least 15 mg\/week) but no more than 25 mg\/week for the treatment of RA. Potential subjects were required to have RA at the time of screening.\u003C\/p\u003E\n      \u003Cp id=\u0022p-6\u0022\u003EThose with moderately active RA (DAS28\u0026gt;3.2 and \u22645.1) who achieved DAS28 low disease activity (DAS\u22643.2, average from Weeks 12 to 36) or remission (DAS28\u0026lt;2.6) on E5O\/M at Week 36 of Period 1 entered the double-blind Period 2. A total of 604 subjects were randomized based on DAS28 low disease activity\/remission to E50\/M (n=202), E25\/M (n=202), or P\/M (n=200) for 52 weeks. MTX was maintained at the same dose throughout the trial (15 to 25 mg).\u003C\/p\u003E\n      \u003Cp id=\u0022p-7\u0022\u003EIn all, 497 subjects completed Period 2. The percent of subjects maintaining DAS28 low disease activity at Week 88 was significantly higher in the E50\/M (82.6%) and E25\/M (79.1%) groups compared with the P\/M group (42.6%; p\u0026lt;0.0001 vs either etanercept group). Significantly more subjects had a DAS28 score \u0026lt;2.6 at Week 88 on E50\/M (66.7%) and E25\/M (60.2%) compared with P\/M (29.4%; p\u0026lt;0.0001 vs either etanercept group).\u003C\/p\u003E\n      \u003Cp id=\u0022p-8\u0022\u003ESignificantly more subjects on E50\/M and E25\/M achieved SDAI low disease activity and remission, ACR 20\/50\/70 responses, and a normal HAQ score (\u22640.5) compared with P\/M (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). There was a significant change in the modified total Sharp score (units\/y) from baseline between the E50\/M (\u20130.06) and P\/M (0.60; p=0.0259) groups, but not between the E25\/M (0.05) and P\/M (0.60; p=0.0696) groups, or the E50\/M and E25\/M (p=0.6737) groups. No significant differences in safety were observed. Among subjects, 35 (5.8%) reported serious adverse events, including 2 deaths (0.3%) in the E50\/M group due to pulmonary embolism and septicemia during Period 2.\u003C\/p\u003E\n      \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\n         \u003Cdiv class=\u0022table-inline\u0022\u003E\n            \u003Cdiv class=\u0022callout\u0022\u003E\n               \u003Cspan\u003EView this table:\u003C\/span\u003E\n               \u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12622\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12622\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12622\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\n            \u003C\/div\u003E\n         \u003C\/div\u003E\n         \u003Cdiv class=\u0022table-caption\u0022\u003E\n            \u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EEffects of Different Treatment Regimens.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\n      \u003Cp id=\u0022p-17\u0022\u003EPRESERVE, the first trial in adults with moderately active RA despite MTX treatment, evaluated induction of DAS28 low disease activity, as well as clinical, functional, and radiographic outcomes with etanercept full-dose continuation, reduction, or elimination on a background of MTX. Subjects were significantly more likely to successfully maintain DAS28 low disease activity (and other clinical benefits) over 52 weeks with the two etanercept treatment regimens than with a step down to P\/M. Further research is needed on the longer term implications of these 52-week observations.\u003C\/p\u003E\n      \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\n         \u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\n            \n               \u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/13\/18\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The editors would like to thank the many members of the American College of Rheumatology 2011 Annual Meeting presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1975266955\u0022 data-figure-caption=\u0022The editors would like to thank the many members of the American College of Rheumatology 2011 Annual Meeting presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/13\/18\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\n            \n            \n         \u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/13\/18\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/13\/18\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12621\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\n         \u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\n            \u003Cp id=\u0022p-18\u0022 class=\u0022first-child\u0022\u003EThe editors would like to thank the many members of the American College of Rheumatology 2011 Annual Meeting presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\n   \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/13\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmw81\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmw81\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmw81\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}