In a nutshell
This study investigated the effectiveness and safety of rupatadine (RUP; Rupafin) and montelukast (MON; Singulair) as additive therapies for patients with rheumatoid arthritis (RA). The authors concluded that RUP and MON provided clinical and functional improvements in these patients.
Some background
RA is a chronic autoimmune, inflammatory disease. It leads to joint inflammation, deformities, bone damage, pain and disabilities. Methotrexate (MTX; Otrexup) is considered as first-line therapy for RA. Advanced, biological therapies that target specific inflammatory proteins are available for patients with RA. The main scale used to measure how advanced the disease is at a certain time point is the 28-joint count disease activity scores (DAS-28). However, identifying patients with moderate disease activity that should qualify for advanced therapies can be difficult.
Other treatments such as anti-allergy or anti-asthmatic medications can also impact inflammation. Previous evidence has suggested that RUP, an antihistamine used for allergies, and MON, a medication used to control asthma, may help in improving RA symptoms. However, there is little evidence of the effectiveness of these medications as add-ons to MTX in patients with RA.
Methods & findings
This study included 75 patients with RA. 25 patients were each assigned to 3 treatment groups. Group 1 patients received MTX and placebo. Group 2 patients received MTX and 10 mg of RUP, once daily for 3 months. Group 3 patients received MTX and 10 mg of MON, once daily for 3 months.
Inflammatory markers such as high sensitivity C-reactive protein (hs-CRP), interleukin-1 (IL-1), interleukin-17 (IL-17), E-selectin, and clusterin (CLU) levels, were evaluated before and after 3 months of treatment. Clinical and functional assessments were also done.
Significant improvements in pain, fatigue, quality of life, and DAS-28 scores were seen in group 3. Group 2 had significant improvements in all these parameters except for fatigue. Group 1 had only slight improvements in these parameters. There were also significant improvements in inflammation biomarker levels in groups 2 and 3.
Sleepiness was reported as a side effect of RUP. In the MON group, headache and depression were reported.
The bottom line
The data showed that RUP and MON can potentially serve as add-on therapies in patients with RA.
The fine print
The study had a short follow-up period and a small number of participants.
Published By :
European journal of clinical pharmacology
Date :
Jul 04, 2021
