Drug combinations show excellent results in rheumatoid arthritis patients

This study examined whether adding infliximab (Remicade) to a combination of treatments improved long-term outcome in rheumatoid arthritis (RA). The study concluded that a combination of treatments resulted in disease remission and prevented the disease from getting worse. Adding infliximab did not improve remission rates. 

The main goal of RA treatment is remission (no symptom of disease) and to slow disease progression. Typically, the first line of treatment in early RA is a single drug, such as methotrexate (Trexall). Combining infliximab with methotrexate has been shown to be an effective treatment combination.

Previous studies have shown that a combination of drugs, such as methotrexate, sulfasalazine (Azulfidine), hydroxychloroquine (Plaquenil), and prednisolone (Prelone), was more effective than a single drug on its own. It is not clear whether adding infliximab to this combination would improve remission rates.

The current study examined the benefit of adding infliximab to a combination of methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone. The study followed 91 RA patients for five years. Patients were randomly assigned to add either infliximab or placebo (substance with no effect on the body) to the four-drug combination. Patients were treated for 6 months.

After five years, 60% of patients of patients treated with infliximab and 61% of patients receiving placebo achieved disease remission. Both groups also had minimal progression of joint damage. There was no difference in adverse events between the groups.

The study concluded that in early RA, a combination of treatments achieves remission and minimizes disease progression in most patients for up to five years. The addition of infliximab did not affect remission rates. 

This was a small study of only 91 patients.