Khalvat A, Rostamian A, Najafizadeh S.R, Meisami A.P. The comparison between monotherapy and combination therapy in Rheumatoid Arthritis. Tehran Univ Med J 2006; 64 (11) :69-76
URL:
http://tumj.tums.ac.ir/article-1-876-en.html
Abstract: (9391 Views)
Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition.
The condition can affected many tissues throught out the body, but the joints
are usually most severely affected. The high incidence of RA, the conventional
treatments and the experimental observation have shown by combination
therapy, the disease symptoms of the patients reduce. To compare the efficacy
and tolerability of single-agent Hydroxychloroquin (HCQ) with combination
therapies composed of (HCQ) and Methotrexate (MTX) and (HCQ), (MTX) and
Sulfasalazin (SSZ) in active rheumatoid arthritis patients with additive arthritis.
Methods: One hundred and twenty RA patients with active arthritis
(male/female: 30/90) who were treated in rheumatology clinic between 2003
and 2005 were enrolled in this trial. Patients treated with (HCQ) alone(200
mg/day)were include in group (I), patients treated with combination of (HCQ)
(200 mg/day)and (MTX) (7.5mg/week)in group (II),and patents treated with
combination of (HCQ) (200mg/day),(MTX) (7.5mg/week)and (SSZ)(1 gr/day)in
group (III), Forty patients (male/female:10/30) in group (I),(II) and (III)were
eligible for statistical analysis at the end of study. Changes in variable were
compared by the T-test.
Results: The combination of (MTX), (HCQ)and (SSZ) and the combination of
(MTX) and (HCQ) were more effective regarding the clinical and laboratory
parameters than (HCQ) alone (P<0.05). Moreover the combination of (MTX),
(HCQ) and (SSZ) was more effective than the combination of (MTX) and (HCQ)
(P<0.05). Combination therapies seem to be more effective and no more toxic
than monotherapy in RA patients with additive arthritis.
Conclusion: Combination therapy with methotrexate, hydroxychloroquin and
sulfasalazin is more effective than hydroxychloroquin alone or a combination
of methotrexate and hydroxychloroquin in RA. We suggest starting
combination therapy for the patients with early RA, when the diagnosis has
been established.