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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\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses results from the late-breaking Study Comparing the Effect on Disease Activity When Reducing or Discontinuing Etanercept in Subjects with RA [DOSERA; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00858780\u0026amp;atom=%2Fspmdc%2F12%2F19%2F16.atom\u0022\u003ENCT00858780\u003C\/a\u003E]. The results showed that in patients with rheumatoid arthritis and stable low disease activity on methotrexate plus etanercept, continued treatment with etanercept at 25 or 50 mg\/week provides a significantly higher likelihood of maintaining a stable disease state over 48 weeks than placebo.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERheumatology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERheumatoid Arthritis\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EResults from the late-breaking Study Comparing the Effect on Disease Activity When Reducing or Discontinuing Etanercept in Subjects with RA [DOSERA; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00858780\u0026amp;atom=%2Fspmdc%2F12%2F19%2F16.atom\u0022\u003ENCT00858780\u003C\/a\u003E] were reported by Ronald F. van Vollenhoven, MD, Karolinska Institute, Stockholm, Sweden. The results showed that in patients with rheumatoid arthritis (RA) and stable low disease activity on methotrexate plus etanercept, continued treatment with etanercept at 25 or 50 mg\/week provides a significantly higher likelihood of maintaining a stable disease state over 48 weeks than placebo. Discontinuation of etanercept leads to worsening.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EEtanercept has been shown to have sustained efficacy over 3 years, and it has a favorable safety profile [Klareskog L et al. \u003Cem\u003EAnn Rheum Dis\u003C\/em\u003E 2006]. Its efficacy in combination with methotrexate in the treatment of RA is well established [Rexhepi S et al. \u003Cem\u003EArthritis Res Ther\u003C\/em\u003E 2012]; however, it is not known whether etanercept must be continued to maintain low disease activity\/remission (LDA\/REM) or if the continuation of methotrexate alone or with a lower dose of etanercept might be equally effective.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThis was a randomized, double-blind, 3-arm study conducted in 5 Northern European countries. Adult patients with RA treated with stable background methotrexate (7.5 to 25 mg\/week) plus etanercept (50 mg\/week) for \u226514 months, with a 28-joint Disease Activity Score (DAS28) \u22643.2 for at least 11 months were randomized (1:1:1) to methotrexate plus etanercept 50 mg\/week (etanercept50), etanercept 25 mg\/week (etanercept25), or placebo. The primary study outcome was the proportion of patients in the etanercept50 group who were nonfailures at 48 weeks. Failure was defined as DAS28 \u0026gt;3.2 and increased by 0.6 or disease progression determined by investigator or subject. Secondary outcomes included comparisons of nonfailure and DAS28 outcomes for all 3 groups, and time to failure. The primary outcome was analyzed using a Generalized Estimating Equation model and expressed as the odds ratio (OR; 95% CI) for achieving nonfailure. Patients were followed for 2 months without major changes in therapy to ensure stable LDA\/REM and stratified based on LDA\/REM status. Seventy-three patients were randomized, 70% were women, mean age was 57 years, and mean duration of etanercept treatment was 3.88 years. Twenty percent of subjects were in remission and 5% had low disease activity. Mean DAS28 score at the start of etanercept treatment was 5.0.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAfter 48 weeks, the proportion of nonfailures was 52% for etanercept50 (OR, 7.2; 95% CI, 1.7 to 29.8; p=0.007 vs placebo) and 44% for etanercept25 (OR, 4.2; 95% CI, 1.0 to 17.0; p=0.044 vs placebo; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Median time to failure was 6 weeks from randomization for placebo, and 48 and 36 weeks for etanercept50 and etanercept25, respectively. Adverse events were similar between the groups and no unexpected safety signals were noted.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/19\/16\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Nonfailures at Week 48.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1523832316\u0022 data-figure-caption=\u0022Nonfailures at Week 48.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/19\/16\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\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\/12\/19\/16\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\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\/12\/19\/16\/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\/11705\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\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003ENonfailures at Week 48.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EETN=etanercept; MTX=methotrexate; PBO=placebo.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EAdapted from RF van Vollenhoven, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThe data suggest that induction-maintenance may be possible with etanercept for some RA patients, even in established disease.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\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\/12\/19\/16.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?nzn5hd\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?nzn5hd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}