Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Prior DMARD Use in RA May Limit Adalimumab Treatment Response

Key clinical point: Patients with established rheumatoid arthritis who have taken two or more prior conventional synthetic DMARDs may show less improvement on adalimumab.

Major finding: RA patients who had used two or more conventional synthetic DMARDs had less improvement in DAS28-CRP, compared with those who had used one or no DMARDs (–1.8 vs. –2.2).

Study details: The data come from a pair of randomized trials including 274 patients with established RA who were treated with adalimumab and methotrexate.

Disclosures: The study was sponsored by AbbVie. Dr. Aletaha disclosed grants and consulting fees from AbbVie, as well as other pharmaceutical companies. Four of the authors were current or former employees of AbbVie, and some other authors also reported financial relationships with the company.


Aletaha D et al. Ann Rheum Dis. 2019 Aug 21. doi: 10.1136/annrheumdis-2018-214918.