12 research outputs found

    The 6-month safety and efficacy of abatacept in patients with rheumatoid arthritis who underwent a washout after anti-tumour necrosis factor therapy or were directly switched to abatacept: the ARRIVE trial

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    To assess the safety, tolerability and efficacy of abatacept in patients with rheumatoid arthritis (RA) who had failed anti-tumour necrosis factor (TNF) therapy and were switched to abatacept directly or after completing washout

    Clinical response to golimumab in rheumatoid arthritis patients who were receiving etanercept or adalimumab: results of a multicenter active treatment study

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    <p><b>Objective:</b> Evaluate the efficacy and safety of subcutaneous (SC) golimumab + methotrexate (MTX) in patients with active rheumatoid arthritis (RA) despite etanercept + MTX or adalimumab + MTX therapy and evaluate whether intravenous (IV) golimumab could rescue patients who were nonresponders to SC golimumab.</p> <p><b>Methods:</b> In this multicenter, assessor-blinded, active-switch study of patients with RA (<i>n</i> = 433) with inadequate response to etanercept or adalimumab + MTX, patients continued MTX and received open-label SC golimumab 50 mg every 4 weeks through week 12. DAS28-ESR good responders at week 16 continued open-label SC golimumab through week 52 (Group 1); nonresponders were randomized to double-blind golimumab SC 50 mg (Group 2-SC) or IV 2 mg/kg (Group 2-IV). Week 14 ACR20 was the primary endpoint; assessments continued through week 52 and for patients in the voluntary long-term extension through week 76. A major secondary endpoint was the proportions of patients with ACR20 response at week 52 relative to week 16 in Group 2-SC and Group 2-IV.</p> <p><b>Results:</b> At week 14, 34.9% (<i>p</i> < 0.001) achieved an ACR20. At week 52, patients in Group 1 (<i>n</i> = 75) achieved an ACR20 (62.7%). In Groups 2-SC (<i>n</i> = 91) and 2-IV (<i>n</i> = 184), 13.2% and 9.2% had an ACR20 at week 52 relative to week 16, with no significant difference between the randomized groups; 42.9% and 47.8% achieved DAS28-ESR response relative to week 0. Through week 16, 4.6% of patients had a serious adverse event. No differences in the rates or types of adverse events were observed between SC and IV golimumab from weeks 16 to 52. The trial limitations included a higher than expected discontinuation rate as a result of a programming error.</p> <p><b>Conclusion:</b> SC golimumab + MTX significantly suppressed disease activity in RA patients with inadequate response to etanercept and/or adalimumab + MTX. Patients randomized to Groups 2-SC and 2-IV had lower response rates than Group 1, with no difference between SC or IV mode of administration. The safety profile with IV golimumab was comparable to that established with SC golimumab.</p> <p><b>Trial registration:</b> NCT01004432, EudraCT 2009-010582-23.</p

    China’s Food Security: Is it a National, Regional or Global Issue?

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    The maintenance of high levels of food security (with over 95 per cent self-sufficiency in grains is a policy that was officially introduced in 1996 and has been implemented thereafter) is a political imperative in China, but not a physical or economic issue now nor in the period to 2030 and probably longer. Supply projections by the Centre for Chinese Agricultural Policy (CCAP) and FAO projections suggest that on average China could continue to be self-sufficient for rice and wheat until 2030. Only soya bean and maize imports for livestock feed will continue to rise. Soya bean and maize imports may increase from the current nearly 60 Mt to 100Mt and to 30 Mt per annum respectively by 2030, which will require a major yet feasible expansion in production in its traditional sources (USA, Brazil and Argentina) or new ones. But this will not be an economic issue. Such imports will require a minute fraction (considerably less than 1 per cent) of China’s more than £2 trillion foreign exchange reserves (using an exchange rate of 9.5 yuan to the £ here and elsewhere in the chapter)
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