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Program Faculty

Program Faculty. Scientific Committee. Participants. Carole Bertrand, MD Terrebonne, QC Louis Bessette, MD Quebec, QC George Ecker , MD Fredericton, NB Shahin Jamal, MD Vancouver, BC Ariel Masetto , MD Sherbrooke , QC Robert Charles Offer, MD Penticton, BC.

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Program Faculty

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  1. Program Faculty Scientific Committee Participants Carole Bertrand, MDTerrebonne, QC Louis Bessette, MDQuebec, QC George Ecker, MDFredericton, NB Shahin Jamal, MDVancouver, BC Ariel Masetto, MDSherbrooke, QC Robert Charles Offer, MDPenticton, BC • MajedKhraishi, MDSt. John's, NF • Janet Pope, MDLondon, ON • Anthony Russell, MDEdmonton, AB

  2. Rheumatoid Arthritis Highlights of EULAR 2013 Compiled by:Louis Bessette, MDGeorge Ecker, MDShahin Jamal, MDMajed Khraishi, MD Robert Charles Offer, MD Anthony Russell, MD

  3. Burmester G, et al. Presented at EULAR 2013; Abstract #OP0067.

  4. Effect of Methotrexate Dosing on Adalimumab Efficacy, Pharmacokinetics, and Safety: CONCERTO Study Clinical Question: What is the effect of methotrexate (MTX) dose in combination with adalimumab in patients with early rheumatoid arthritis (RA)? Methods: 26-week, double-blind, trial in MTX and biologic-naïve patients with active RA of < 1 year duration in the Study to Determine the Effects of Different Doses of MTX When Taken With Adalimumab in Subjects With Early RA (CONCERTO) • Patients were randomized 1:1:1:1 to weekly oral MTX (2.5, 5, 10, or 20 mg) and received open-label adalimumab 40 mg every other week (EOW) Burmester G, et al. Presented at EULAR 2013; Abstract #OP0067.

  5. Proportion of Patients Achieving Low Disease Activity or Remission (DAS28[CRP]) Over Six Months: CONCERTO Study 60 0 40 30 70 60 50 10 20 57 Adalimumab + MTX 2.5 mg(n = 98) 45 44 43 Adalimumab + MTX 5 mg(n = 100) 37 Patients achieving DAS28 < 2.6(%) 32 Adalimumab + MTX 10 mg(n = 99) 28 Adalimumab + MTX 20 mg(n = 98) LDAS (primary endpoint)* DAS28 remission** *Low disease activity (LDAS): Disease Activity Score (DAS28) C-Reactive Protein (CRP) < 3.2;**Remission: DAS28(CRP) < 2.6. p values for trends: p = 0.005 for LDAS, p = 0.008 for remission. Burmester G, et al. Presented at EULAR 2013; Abstract #OP0067.

  6. Which Dose of MTX? CONCERTO: Safety Summary • Additional safety results: • Only the proportion of patients experiencing infectious AEs increased with increasing MTX dose; serious infectious events did not increase • All other AEs occurred in < 2% of all randomized patients • No obvious trends existed pertaining to liver function tests • Infections and abnormal hair loss increased with increasing MTX dose Burmester G, et al. Presented at EULAR 2013; Abstract #OP0067.

  7. Effect of Methotrexate Dosing on Adalimumab Efficacy, Pharmacokinetics, and Safety: CONCERTO Study Take-home Messages: In combination with adalimumab, higher dosages of MTX (> 10 mg) are better If there are side effects on 20 mg and/or the patient is in remission/LDAS, it may be appropriate to reduce the MTX dose to 10 mg Burmester G, et al. Presented at EULAR 2013; Abstract #OP0067.

  8. Gaujoux-Viala C, et al. Presented at EULAR 2013; Abstract #THU0221.

  9. Optimization of MTX: Data from the French ESPOIR Cohort Clinical Question: What is the symptomatic and structural impact of MTX optimization in early arthritis (EA) in daily clinical practice over two years? Methods: Patients were considered “optimized” if started > 10 mg MTX per week and > 20 mg by six months Gaujoux-Viala C, et al. Presented at EULAR 2013; Abstract #THU0221.

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