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- Title
Efficacy of denosumab with regard to bone destruction in prognostic subgroups of Japanese rheumatoid arthritis patients from the phase II DRIVE study.
- Authors
Ishiguro, Naoki; Tanaka, Yoshiya; Yamanaka, Hisashi; Yoneda, Toshiyuki; Ohira, Takeshi; Okubo, Naoki; Genant, Harry K; Heijde, Désirée van der; Takeuchi, Tsutomu
- Abstract
Objectives To evaluate the efficacy of denosumab for progressive bone erosion in risk factor subgroups of Japanese RA patients. Methods This study included 340 RA patients on MTX from the dose-response study of Denosumab in patients with RheumatoId arthritis on methotrexate to Validate inhibitory effect on bone Erosion (DRIVE study-a 12-month, multicentre, randomized, double-blind, placebo-controlled, phase II study). The patients were randomized to receive placebo or denosumab 60 mg every 6 months, 3 months or 2 months. Subgroup analyses involved baseline RF, ACPA, swollen joint count, CRP level, RA duration, ESR and glucocorticoid use. Results Patients with risk factor positivity generally showed consistent results for the primary endpoint of the change in the modified Sharp erosion score at 12 months from baseline. In the placebo, every 6 months, every 3 months and every 2 months groups, the mean changes in the erosion score, according to the RF status (RF-positive vs -negative subgroups), were 1.18 vs 0.59, 0.25 (P = 0.0601 vs placebo) vs 0.31 (P = 0.0827), 0.21 (P = 0.0422) vs −0.02 (P = 0.0631) and 0.15 (P = 0.0010) vs −0.05 (P = 0.0332), respectively, while the mean changes in the erosion score, according to the ACPA status (ACPA-positive vs -negative subgroups), were 1.30 vs 0.07, 0.26 (P = 0.0142) vs 0.33 (P = 0.2748), 0.16 (P = 0.0058) vs 0.08 (P = 0.7166) and 0.09 (P < 0.0001) vs 0.08 (P = 0.8939), respectively. Conclusion Denosumab is a potentially useful treatment option for RA patients who are positive for RF, ACPA and other possible risk factors. Trial registration JAPIC Clinical Trials Information, http://www.clinicaltrials.jp/user/cteSearch%5fe.jsp, JapicCTI-101263.
- Subjects
JAPAN; DENOSUMAB; METHOTREXATE; THERAPEUTIC use of monoclonal antibodies; BONE resorption; BLOOD sedimentation; C-reactive protein; DOSE-response relationship in biochemistry; JOINTS (Anatomy); MONOCLONAL antibodies; DECISION making in clinical medicine; RHEUMATOID arthritis; RANDOMIZED controlled trials; TREATMENT effectiveness; DISEASE duration; PROGNOSIS; DISEASE risk factors
- Publication
Rheumatology, 2019, Vol 58, Issue 6, p997
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/key416