UpdatesPlus - EULAR 2014 - MTX reportedly increases Humira drug survival in AS

The alert below is from our EULAR 2014 coverage.  We have captured most of the key oral and poster presentations delivered at EULAR and will be analyzing these more comprehensively in upcoming issues of our UpdatesPlus service.  UpdatesPlus is a service comprising alerts and monthly reports including pipeline and trial updates plus analysis of key information.  The service is designed for industry and academics across the immunology & Inflammation spectrum.  To register for UpdatesPlus or to get further information please contactfiona.watts@leaddiscovery.co.uk 

• Approximately 40% AS patients fail to respond to TNFis and the development of  anti-drug antibodies is a risk-factors for treatment failure, particularly in patients treated with Humira
• The CONCERTO study has recently reported that MTX up to 10mg increased Humira serum concentrations and reduced antidrug antibodies
• Current guidelines do not recommend the use of MTX alongside biologics in the treatment of AS
• Taiwanese researchers reported on the survival of Enbrel or Humira treatment using AS data sampled from national insurance records
• The analysis reported that concomitant MTX had no significant effect on Enbrel survival but produced a large increase in Humira retention.  Stratification of the Humira data reported that doses below 10mg/wk were superior to higher doses
  

Comments:  The benefit of concomitant MTX use in Humira treated patients is as expected and consistent with the RA literature.  The MTX dose response is similar and we presume that patients receiving greater than 10mg MTX may have discontinued MTX due to AEs, in turn reducing Humira survival.  Lower doses of MTX are generally used in Asian patients and further study of MTX benefit would be required in a Caucasian cohort