Document Detail


Combination therapy versus monotherapy for the treatment of patients with rheumatoid arthritis.
MedLine Citation:
PMID:  10609068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The response to single disease modifying antirheumatic drug (DMARD) is often suboptimal in patients with rheumatoid arthritis (RA). Thus, despite the limited data on the therapeutic efficacy of combination therapies, many patients are currently treated with a combination of DMARDs. METHODS: We studied prospectively the efficacy of combination therapy with DMARDs. The study was designed as a randomized trial and a single DMARD or two or three DMARD combinations were administered to 180 consecutive, age- and sex-matched patients with active RA, each of whom was followed up for a period of 2 years under treatment. Patients were divided into 3 groups which did not differ with regard to demographic, clinical and laboratory parameters. Patients in group I were treated with a single DMARD [methotrexate (MTX) 7.5-15 mg/week or sulfasalazine (SSZ) 1-2 g/day or hydroxychloroquine (HCQ) 200 mg/day], group II with MTX + SSZ or MTX + HCQ, and group III with a combination of all three drugs. Patients were re-evaluated at regular intervals by means of clinical and biochemical tests designed to detect specific rheumatic activity. Radiological assessments were also performed and scored according to Larsen by the same radiologist who was blinded to the treatment groups. RESULTS: At the end of the trial there were significant improvements in the clinical and laboratory parameters in all 3 groups. However, improvements were greater and much more significant in the patients who were given combination therapies. The combination of MTX + SSZ + HCQ was more effective than both monotherapy and the two-drug combinations. CONCLUSION: In conclusion, we suggest that patients with RA should be treated with combinations of DMARDs.
Authors:
M Calgüneri; S Pay; Z Calişkaner; S Apraş; S Kiraz; I Ertenli; V Cobankara
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  17     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    1999 Nov-Dec
Date Detail:
Created Date:  2000-01-12     Completed Date:  2000-01-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  699-704     Citation Subset:  IM    
Affiliation:
Hacettepe University School of Medicine, Department of Rheumatology, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  radiography
Arthrography
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Hydroxychloroquine / therapeutic use*
Male
Methotrexate / therapeutic use*
Middle Aged
Prospective Studies
Sulfasalazine / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 118-42-3/Hydroxychloroquine; 59-05-2/Methotrexate; 599-79-1/Sulfasalazine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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