Early Treatment Sees High Rheumatoid Arthritis Remission Rates

By Danielle Bradshaw from In The Cloud Copy

In a six-month long early rheumatoid arthritis (RA) trial – which was called NORD-STAR – researchers reported at the European League Against Rheumatism’s virtual meeting that there was a high rate of remission.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is a long-term autoimmune disorder that mainly affects the joints, although it can sometimes cause problems with the organs as well. The most common symptom is painful, warm, swollen joints with pain (as well as some stiffness) becoming more pronounced after rest.

Deformation due to swelling (of the hands, for example) can occur, but with proper treatment, it’s not very common. Inflammation of the heart, lungs, and low red blood cell count can occur as well. It’s not really known what exactly causes RA, but it’s thought to be caused by both a person’s genetics and environment.

How the Study Was Conducted

The NORD-STAR study was a series of random tests performed at multiple centers throughout Sweden, Finland, and Norway that was conducted to gather data as to whether receiving early treatment for RA is effective. All of the participating patients were not treated beforehand for the disorder and had Disease Activity Scores in 28 of their joints (DAS28).

They also had to have rheumatoid factor (RF), C-reactive protein levels above 10 mg/L, and anticitrullinated protein antibodies or ACPA. The final requirement participants needed to qualify for the trial was that they needed to have at least two tender, swollen joints.

The group of participants had a mean age of 54 and approximately two-thirds of them were women. Collectively, the group had a mean body mass index (BMI) of 26.2 with 74.9% of the group being RF positive, and around 82% of them being ACPA positive. The patient group’s baseline CDAI and DAS28 were 28.6 and 5 respectively.

The patients were split into four separate groups – conventional therapy, tocilizumab (Actemra), certolizumab pegol (Cimzia), and abatacept (Orencia). All four groups were given methotrexate in 25mg doses every week after the first month of testing. 24 weeks into the trial, the remission rate for each group was over 40%.

The simplified disease activity index was much the same. Each group was around the 40 to 50% range; the tocilizumab, abatacept, and certolizumab groups saw remission around 41%, 52.5%, and 47.8% respectively, while the conventional therapy group had around 42% remission.

The Study Results

Results of the Conventional Therapy Testing

The patient’s active conventional therapy consisted of hydroxychloroquine, intra-articular glucocorticoid injections in their swollen joints, methotrexate plus sulfasalazine, and methotrexate plus quickly tapered oral prednisolone. The Clinical Disease Activity (CDAI) noted that a combination of all four of these treatments resulted in significant remission rates in 42% of the participants.

As the results show, the abatacept displayed the greatest difference from conventional therapy.

There was also testing conducted to compare the test products to their competitors that did a bit of tweaking to the general countries, BMI, baseline DAS28, ACPA rating, sex, and age. These tests had a 15% margin that had already been determined and it was found that while the conventional treatment was on par with tocilizumab and certolizumab, abatacept was the drug with better performance.

Learn more about this study here.

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