Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies

Peter A Fischer,1 Ronald J Rapoport2 1Sturdy Memorial Hospital, Attleboro, MA, USA; 2Division of Rheumatology, Southcoast Health, Fall River, MA, USA Introduction: Although synthetic and biologic disease-modifying antirheumatic drugs are available, many patients with rheumatoid arthritis have a diff...

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Autores principales:	Fischer PA, Rapoport RJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Repository corticotropin injection Rheumatoid arthritis Disease Activity Score 28 using C-Reactive Protein (DAS28-CRP) Health-related quality of life Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/8356bffd7b4141b59310bf5a2dad5e66
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spelling	oai:doaj.org-article:8356bffd7b4141b59310bf5a2dad5e662021-12-02T00:53:25ZRepository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies1179-156Xhttps://doaj.org/article/8356bffd7b4141b59310bf5a2dad5e662018-02-01T00:00:00Zhttps://www.dovepress.com/repository-corticotropin-injection-in-patients-with-rheumatoid-arthrit-peer-reviewed-article-OARRRhttps://doaj.org/toc/1179-156XPeter A Fischer,1 Ronald J Rapoport2 1Sturdy Memorial Hospital, Attleboro, MA, USA; 2Division of Rheumatology, Southcoast Health, Fall River, MA, USA Introduction: Although synthetic and biologic disease-modifying antirheumatic drugs are available, many patients with rheumatoid arthritis have a difficult-to-control disease and need other treatment options. Repository corticotropin injection (RCI) may alleviate symptoms and exacerbations in patients with refractory disease. Methods: Nine patients with refractory rheumatoid arthritis were included in this study. Patients were maintained on their baseline therapies with a minimum of 7.5 mg prednisone daily. RCI was given daily at 40 U for 7 days. Patients who had an adequate disease response were given 40 U twice weekly through Week 12. For patients who had inadequate disease response, the dose was increased to 80 U daily for 7 days, followed by 80 U twice weekly through Week 12. Results: The primary endpoint was >1.2 point reduction in the Disease Activity Score 28 using C-reactive protein (DAS28-CRP) at Week 12. Secondary endpoints were improvements in Health Assessment Questionnaire-Disease Index and Functional Assessment of Chronic Illness Therapy scores. Six of the nine patients met the primary endpoint. The average change in DAS28-CRP from baseline to Week 12 was numerically greater with 40 U than with 80 U RCI. Functional Assessment of Chronic Illness Therapy and Health Assessment Questionnaire-Disease Index improved as early as Week 1, and the improvements remained throughout treatment. Conclusion: There was no association between cortisol levels and low-dose RCI response. No serious adverse events occurred. RCI produced a clinically meaningful reduction in markers of disease activity, improved health-related quality of life, and a favorable safety profile. The response rate to RCI was substantial and shows promise in this difficult-to-treat population. Keywords: repository corticotropin injection, rheumatoid arthritis, Disease Activity Score 28 using C-reactive protein (DAS28-CRP), health-related quality of life, biologic failure, melanocortin, refractory rheumatoid arthritisFischer PARapoport RJDove Medical PressarticleRepository corticotropin injection Rheumatoid arthritis Disease Activity Score 28 using C-Reactive Protein (DAS28-CRP) Health-related quality of lifeDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 10, Pp 13-19 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Repository corticotropin injection Rheumatoid arthritis Disease Activity Score 28 using C-Reactive Protein (DAS28-CRP) Health-related quality of life Diseases of the musculoskeletal system RC925-935
spellingShingle	Repository corticotropin injection Rheumatoid arthritis Disease Activity Score 28 using C-Reactive Protein (DAS28-CRP) Health-related quality of life Diseases of the musculoskeletal system RC925-935 Fischer PA Rapoport RJ Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
description	Peter A Fischer,1 Ronald J Rapoport2 1Sturdy Memorial Hospital, Attleboro, MA, USA; 2Division of Rheumatology, Southcoast Health, Fall River, MA, USA Introduction: Although synthetic and biologic disease-modifying antirheumatic drugs are available, many patients with rheumatoid arthritis have a difficult-to-control disease and need other treatment options. Repository corticotropin injection (RCI) may alleviate symptoms and exacerbations in patients with refractory disease. Methods: Nine patients with refractory rheumatoid arthritis were included in this study. Patients were maintained on their baseline therapies with a minimum of 7.5 mg prednisone daily. RCI was given daily at 40 U for 7 days. Patients who had an adequate disease response were given 40 U twice weekly through Week 12. For patients who had inadequate disease response, the dose was increased to 80 U daily for 7 days, followed by 80 U twice weekly through Week 12. Results: The primary endpoint was >1.2 point reduction in the Disease Activity Score 28 using C-reactive protein (DAS28-CRP) at Week 12. Secondary endpoints were improvements in Health Assessment Questionnaire-Disease Index and Functional Assessment of Chronic Illness Therapy scores. Six of the nine patients met the primary endpoint. The average change in DAS28-CRP from baseline to Week 12 was numerically greater with 40 U than with 80 U RCI. Functional Assessment of Chronic Illness Therapy and Health Assessment Questionnaire-Disease Index improved as early as Week 1, and the improvements remained throughout treatment. Conclusion: There was no association between cortisol levels and low-dose RCI response. No serious adverse events occurred. RCI produced a clinically meaningful reduction in markers of disease activity, improved health-related quality of life, and a favorable safety profile. The response rate to RCI was substantial and shows promise in this difficult-to-treat population. Keywords: repository corticotropin injection, rheumatoid arthritis, Disease Activity Score 28 using C-reactive protein (DAS28-CRP), health-related quality of life, biologic failure, melanocortin, refractory rheumatoid arthritis
format	article
author	Fischer PA Rapoport RJ
author_facet	Fischer PA Rapoport RJ
author_sort	Fischer PA
title	Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
title_short	Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
title_full	Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
title_fullStr	Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
title_full_unstemmed	Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
title_sort	repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/8356bffd7b4141b59310bf5a2dad5e66
work_keys_str_mv	AT fischerpa repositorycorticotropininjectioninpatientswithrheumatoidarthritisresistanttobiologictherapies AT rapoportrj repositorycorticotropininjectioninpatientswithrheumatoidarthritisresistanttobiologictherapies
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Repository corticotropin injection in patients with rheumatoid arthritis resistant to biologic therapies

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