Dec 7, 2002

The rheumatoid arthritis patient in the clinic: comparing more than 1,300 consecutive DMARD courses

Rheumatology
Daniel Aletaha, Josef S Smolen

Abstract

Therapy of rheumatoid arthritis (RA) is typically characterized by the sequential use of disease-modifying anti-rheumatic drugs (DMARDs). This study aimed to reveal treatment patterns with traditional DMARDs and their changes during the two decades before the recent introduction of new DMARDs. A total of 593 RA patients were followed from their first presentation to our clinic throughout the course of their disease; 222 patients received their first DMARD therapy while under our care. More than 2,300 patient years of therapy were analysed for the efficacy [using C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as surrogates] and duration of drug therapy of consecutive DMARDs. Before 1985, 65-90% of initial DMARDs were gold compounds, but their use decreased continuously thereafter. Antimalarial (AM) drugs were important initial DMARDs in new patients at all times, whereas sulphasalazine (SSZ) and methotrexate (MTX) gained increasing significance after 1985 (the first DMARD was MTX in up to 29% of new patients). Penicillamine (DPA), azathioprine (AZP), cyclosporin (CyA) and combination therapies were not usually employed initially, but were reserved for the later course of the disease. Gender, age and rheumatoid...Continue Reading

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Mentioned in this Paper

Treatment Protocols
Antirheumatic Drugs, Disease-Modifying
Restasis
Sulfasalazin medac
Polychemotherapy
Acute Disease
Rheumatoid Arthritis
Azathioprine Sulfate
Metalcaptase
Organogold Compounds

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