Aug 16, 2000

Treatment of poor-prognosis early rheumatoid arthritis. A randomized study of treatment with methotrexate, cyclosporin A, and intraarticular corticosteroids compared with sulfasalazine alone

Arthritis and Rheumatism
Susanna M ProudmanP Emery

Abstract

To determine whether a regimen of methotrexate, cyclosporin A, and corticosteroids introduced at onset in poor-prognosis rheumatoid arthritis (RA) can produce a significant improvement in outcome compared with standard monotherapy with sulfasalazine (SSZ). Eighty-two consecutive patients presenting with new, untreated RA of less than 12 months' duration who fulfilled criteria for poor long-term outcome were randomized to receive either combination therapy (n = 40) or SSZ alone (n = 42). The primary outcome measures were remission and American College of Rheumatology (ACR) criteria for 20% improvement at 48 weeks. After 48 weeks, the numbers of patients who met the ACR criteria for 20% improvement were not significantly different between the two groups (combination 58% versus SSZ 45%), and similar numbers of patients had persisting clinical remission (approximately 10% both groups). During the first 3 months, there were significantly greater reductions in parameters of disease activity in the combination group. By 24 weeks, the swollen and tender joint counts, C-reactive protein levels, and erythrocyte sedimentation rates had fallen significantly in both groups, with a greater improvement in the swollen and tender joint count in...Continue Reading

  • References34
  • Citations58

References

  • References34
  • Citations58

Citations

Mentioned in this Paper

Creatinine
Antirheumatic Drugs, Disease-Modifying
Intra-Articular Injections
C-reactive Protein Measurement
Restasis
Cyclosporine
Erythrocyte Sedimentation Rate Measurement
Sulfasalazin medac
Corticosteroids, topical for treatment of hemorrhoids and anal fissures
Polychemotherapy

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