- 3 y after discontinuing adalimumab (ADA), 4 in 5 patients with rheumatoid arthritis (RA) in this observational study remained in low disease activity (LDA), with fewer adverse events than those who continued ADA.
- Continuing ADA led to higher rates of LDA as well as of adverse events.
Why this matters
- Although effective in RA, biological agents like ADA are associated with higher infection risk.
- The long-term safety and efficacy of continuing vs discontinuing ADA have been unclear.
- At wk 208, 95.1% of ADA continuation patients and 79.7% of ADA discontinuation patients had LDA.
- The ADA discontinuation group had significantly fewer adverse events vs continuation group (9.7% vs 32.9%; P<.001).
- HOPEFUL-3 was 2-y observational study of 135 participants of HOPEFUL-2 and -1.
- In HOPEFUL-1, participants were randomly assigned to 26 wk of ADA+methotrexate (MTX) (intensive therapy) or MTX alone, then ADA+MTX for 26 wk.
- In HOPEFUL-2, participants took 52 wk of ADA+MTX (ADA continuation) or MTX alone (ADA discontinuation).
- Primary endpoints: 28-joint Disease Activity Score using C-reactive protein score and achievement of LDA (DAS28-CRP, <3.2) at wk 208.
- Funding: AbbVie GK; Eisai Co., Ltd.
- Observational study.
- HOPEFUL-2 not randomized.
- Steroid use not taken into account.