Infliximab and methotrexate in the treatment of rheumatoid arthritis¶

One-paragraph summary¶

ATTRACT randomized 428 patients with active RA despite methotrexate to placebo or several infliximab dose/interval regimens with continued methotrexate for 54 weeks. It demonstrated sustained clinical responses and inhibition of joint damage, establishing TNF neutralization plus methotrexate as a major treatment advance (PMID 11096166).

Key findings¶

Participants had active disease despite methotrexate.
Multiple infliximab dosing schedules were tested.
Clinical and structural endpoints supported TNF blockade.
Combination with methotrexate became a biologic-development template.

Limitations¶

Trial selection and follow-up do not define rare or very-long-term harms.
Infliximab-specific infusion and immunogenicity issues are not identical across TNF inhibitors.
Modern earlier-treatment populations differ from this refractory cohort.

Why it matters¶

ATTRACT helped transform RA from a largely damage-management disease into one in which targeted therapy could suppress both activity and radiographic progression.

Cited by wiki pages¶

overview
biologic DMARDs
synovial immunobiology