Sequencing of Therapy for Rheumatoid Arthritis - Episode 4

TEAR Trial for Early Aggressive RA and Future Treatment

Cheryl Allen, BS Pharm, MBA: The TEAR trial was “Treatment of Early Rheumatoid Arthritis.” This was a randomized, double-blind study with 755 patients with rheumatoid arthritis with a poor prognosis. The trial was randomized 2:1 into methotrexate alone, methotrexate/etanercept, or methotrexate/hydroxychloroquine/sulfasalazine. So, the results of the TEAR trial showed that treatment with etanercept/methotrexate showed clinically significant radiographic benefit compared with the triple therapy.

So, for the future treatment for rheumatoid arthritis, we believe that methotrexate will continue to be the mainstay. There is clinical significance of using methotrexate early on and continuing through that therapy as long as it is effective. There’s value in offering to patients the subcutaneous form of methotrexate and then moving on to adding anti-TNFs or other biologic products when needed. We see that the pipeline is full of drugs that are coming to market with various mechanisms of action for rheumatoid arthritis treatment, so we’re very excited about where we are today with treatment options and where we’re going in the future.