BeSt Study: Patient Characteristics Total Population Female 67% Male % Age (years) Duration of symptoms (weeks) 23 Time diagnosis.

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Presentation transcript:

BeSt Study: Patient Characteristics Total Population 508 Female 67% Male 33% Age (years) 54 Duration of symptoms (weeks) 23 Time diagnosis – inclusion (weeks) 2 DAS 44 4.4 RF-positive 65% With erosion 72% Sharp/vdHeijde score 4 Population was Early RA, and were Sick/ had active disease Patients had average disease duration of about 6 Months High DAS (Disease Activity) – 4.4 72% already had Joint Erosion at Baseline Adapted from Goekoop-Ruiterman et al. Arthritis Rheum 2005;52(11):3381-90.

Remission Rates for Patients on Initial Methotrexate/Infliximab Treatment for Early RA Adapted from: 1. Allaart et al. Clin Exp Rheumatol 2006;24:S77-S82. 2. Van der Kooij et al. ACR 2006, abstract 658. 3. Van der Kooij et al. EULAR 2007, abstract THU0215. 4. Klarenbeek et al. EULAR 2008, abstract THU0162.

DAS Results for Initial vs DAS Results for Initial vs. Delayed Treatment with IFX + MTX at 2-year follow-up 100 80 P<0.001 56 60 Initial IFX + MTX (n=120) P=0.005 Delayed IFX+ MTX (n=86) 40 28 25 18 15 20 5 Conclusion: Initial treatment with IFX + MTX in patients with early onset RA is more effective than reserving IFX + MTX for patients who failed on previous DMARDs, resulting in more reductions in DAS, HAQ, more patients in clinical remission, and more cases of biolgoic free remission in the patients treated with “initial infliximab”. % failed on IFX + MTX % stopped IFX and still DAS <2.4 % stopped IFX and still DAS <1.6 Delayed: Early RA patients started combination IFX + MTX therapy after failing DMARDs IFX = infliximab MTX = methotrexate Adapted from van der Kooij et al. EULAR 2007, abstract OP0010.

Comparative Reduction in CRP Levels Infliximab 3 mg/kg q 8 + MTX (N=10) 10 20 30 40 50 0 to 54 weeks CRP AUC (P<0.05) MTX alone (N=10) CRP (mg/dL) Infliximab-free period 2 6 14 22 30 38 46 54 62 78 104 Weeks = Infliximab/placebo infusions Adapted from Quinn et al. Arthritis Rheum 2005;52:27-35.

BeSt Safety Results Sequential monotherapy Step-up combination Initial combination with prednisone Initial combination with infliximab 1 adverse event (% of pts) 43% 47% 37% 39% No. of adverse events 54 57 49 50 Gastrointestinal symptoms 16% 15% 8% 11% Rash/mild dermal or mucosal events 10% 12% 9% 6% Infections 4% 7% Cardiovascular events 2% No. of serious adverse events 8 9 17 6 8 infusiereacties, allen zelfde dag weer naar huis. Adapted from Goedkoop-Ruiterman et al. Arthritis Rheum 2005;52:3381-90.