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Posted by on Oct 20, 2018 in Rheumatoid Arthritis | 0 comments

In a nutshell

This study investigated the long-term effectiveness of csDMARDs in patients with rheumatoid arthritis (RA). They found that csDMARDs are effective at managing RA symptoms long-term.

Some background

Managing rheumatoid arthritis (RA) involves taking medication to reduce inflammation. The aim is to achieve the lowest level of disease activity (remission). Disease-modifying anti-rheumatic agents (DMARDs) are used to treat RA. Synthetic DMARDs (csDMARDs) and biological (bDMARDs) are prescribed in combination with other medications. RA may be treated with other drugs to reduce inflammation. Glucocorticoid drugs such as prednisone (PRD), are commonly prescribed to patients with RA.

Patients with early RA benefit from treatment with csDMARDs. Treatment with csDMARDs in combination with other RA drugs may reduce disease activity.  A combination of csDMARDs, PRD and infliximab (IFX), a bDMARD has been tested. Patients on combined treatment have slowed disease progression after 2 and 5 years. The long-term effectiveness of this treatment is not clear.

Methods & findings

This study included 99 patients with early RA at the beginning of the study. Patients in this study took a combination of medications over a 10-year period. All patients received csDMARDs and PRD. In addition, some patients received injections of IFX or placebo (inactive drug) during the first 6 months of the trial. Disease activity was measured using two scales (NEO-RACo and DAS28) between 5 and 10 years.

After 10 years of treatment, 46% of patients in the IFX group and 38% in the placebo group were in remission. According to the DAS28 scale, 82% and 72% or patients (IFX vs. no IFX) were in remission. There was no significant increase in adverse events.

The bottom line

This study concluded that csDMARDs with or without IFX are effective at managing RA symptoms long-term.

The fine print

The number of patients in this study was relatively small. A larger study may be needed to confirm these results. 

What’s next?

If you have any concerns regarding RA treatment, please consult with your physician. 

Published By :

Arthritis Care & Research

Date :

Oct 08, 2018

Original Title :
Early Targeted Combination Treatment with csDMARDs Sustains Excellent Long-term Outcomes in Rheumatoid Arthritis.
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