Apr 5, 2008

Disease-modifying antirheumatic drugs other than methotrexate in rheumatoid arthritis and seronegative arthritis

Current Opinion in Rheumatology
Pradip NandiDavid L Scott

Abstract

To outline recent research findings with nonmethotrexate disease-modifying antirheumatic drugs in rheumatoid arthritis and seronegative arthritis spanning systematic reviews, randomized controlled trials, observational clinical practice trials and assessments of adverse effects. Systematic reviews show no important differences between methotrexate, leflunomide and sulfasalazine monotherapies; early disease-modifying antirheumatic drug therapy reduces erosive progression. Observational studies show that nonmethotrexate disease-modifying antirheumatic drugs are widely prescribed; their usage has increased in the biologic era. A systemic review also showed patients who failed monotherapy benefited from disease-modifying antirheumatic drug combinations without excess toxicity. Randomized controlled trials of intensive initial disease-modifying antirheumatic drug combinations showed they reduce synovitis and erosive damage, especially when used with steroids. The subsequent sequence of disease-modifying antirheumatic drugs and the value of changing disease-modifying antirheumatic drug monotherapies or stepping-up to combination disease-modifying antirheumatic drugs are, however, unresolved. The adverse risks of nonmethotrexate disea...Continue Reading

  • References32
  • Citations13

References

  • References32
  • Citations13

Citations

Mentioned in this Paper

Leflunomide
Antirheumatic Drugs, Disease-Modifying
Gait, Drop Foot
Antirheumatic Agents
Polychemotherapy
Adverse Effects
Cardiovascular Diseases
Seronegative Arthritis
Rheumatoid Arthritis
Arthritis

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