Ann Rheum Dis: Ultra-early randomized controlled trial using Inasip and MTX vs MTX in combination with Inasip delayed treatment ra

This study was designed to confirm that methotrexate in themethotrexate (
ETN-MTX) is better thanMTXtargeted therapy (
MTX-TT) in the ultra-early stage of rheumatoid arthritis (
ERA) (
30%) and higher than previousERAreports (
14%), and explores whether using ETN after initial mTX treatment can ensure a comparable response to the first-line ETN-MTX treatment this is a practical, open-label randomized controlled trial of patients with first-
ERA (symptoms of of 12 months) with a disease activity score of 28 joints (
DAS28 ) -
blood loss (
ESR ) a positive of 3.2, rheumatism factor (
RF ) /- anti-gualine peptide antibodies (
ACPA ) or positive for ultrasonic power Doppler (
PD ) if RF and ACPA negative Subjects were randomly classified as 1 : 1 , or MTX-TT , if the 24 week s/ DAS28-ESR , ETN and injected glucocorticoids at a specified point in time The main endpoint is 48 weeks DAS28-ESR remission, clinical and imaging as secondary endpoints researchers randomly grouped 120 patients in a 60,
(
71 % female) in each group 73 % RF positive, 84 % ACPA positive, median (
IQR ) symptom duration 20.3 (
13.1 , 30.8 ) weeks, average (
SD ) DAS25.1 (
1.1 ) At week 24 the mitigation rates for the ETN-MTX and the MTX-TT were 38 % and 33%
%, respectively The 48 weeks are 52 % and 38 % (
ORs 1.6 , 95 % CI 0.8-3.5 , p .211 ) More persistent DAS28-ESR mitigations were observed in the group of ETN-MTX than MTX-TT (
42 % and 27
%, respectively; p.035 ) By the 48 week, more than 90 % of patients in each group were completely inhibited PD The planned exploration analysis shows that the OR of first-line ETN reaching relief after 24 weeks (
95 % CI 0.8-9.6 ) was compared to the use of ETN after MTX this study does not confirm that etacoel in ERA are more effective than previously reported tumor necrosis inhibitors -MTX first-line therapeutic remission rates vs MTX-TT Although ultrasound confirmed local inflammation inhibition, neither strategy relieved most patients The study also suggested poor response soutcomes ETN after MTX-TT treatment failed