PMID: 9187235Apr 1, 1997Paper

Combination of second-line antirheumatic drugs

Annals of Medicine
C J Haagsma, P L van Riel

Abstract

Single drug therapy is often not satisfactory in the treatment of chronic arthritis. The combination of second-line antirheumatic drugs is therefore increasingly employed. Various strategies of combining drugs can be used, starting with combinations or adding agents in case of insufficient effect of single therapy. Effective combinations have to be found empirically because lack of knowledge about pharmacodynamics and pharmacokinetics often hinders rational choices. Few controlled studies on combinations of second-line antirheumatic drugs exist, results suggesting very moderately increased efficacy and increased toxicity. Recently, results of combinations, mainly with methotrexate, have become available. Combining this agent with azathioprine did not offer advantages. Cyclosporin added to insufficiently effective methotrexate possibly has some value and antimalarials combined with methotrexate may be beneficial regarding effectivity and/or toxicity. Methotrexate added to insufficiently effective sulphasalazine seems to be better than methotrexate alone, although this combination when used from the start of the therapy was disappointing. Triple therapy of the latter combination together with hydroxychloroquine turned out to be s...Continue Reading

References

Oct 1, 1991·Seminars in Arthritis and Rheumatism·W S Wilke, J D Clough
Aug 1, 1991·British Journal of Rheumatology·T Pullar
May 1, 1991·The Journal of Rheumatology·L A Healey, K R Wilske
Dec 1, 1990·British Journal of Rheumatology·A C SchwarzerP M Brooks
Aug 1, 1987·British Journal of Rheumatology·E C Huskisson
Apr 1, 1988·Annals of the Rheumatic Diseases·C AstburyH A Bird
Jul 1, 1994·British Journal of Rheumatology·M NisarR S Amos
Oct 1, 1994·Arthritis and Rheumatism·M E WeinblattE Gall
Feb 1, 1993·Arthritis and Rheumatism·S L MorganG S Alarcón

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Citations

Jan 16, 2013·International Journal of Evolutionary Biology·Germán Avila-Sakar, Cora Anne Romanow
Nov 24, 2007·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·A M Prieur, P Quartier
Sep 30, 1999·Scandinavian Journal of Rheumatology·B RojkovichK Szocsik

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