News - Trio Of Drugs Works Best For Rheumatoid Arthritics In Study

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Trio Of Drugs Works Best For Rheumatoid Arthritics In Study

05/14/2002

By Anne MacLennan

Patients with rheumatoid arthritis tolerate and respond well to the triple

combination of methotrexate, hydroxychloroquine and sulfasalazine.

This three-way mix is superior to a combination of methotrexate (MTX) and

sulfasalazine (SSZ) and marginally superior to MTX plus hydroxychloroquine

(HCQ), suggests this two-year double-blind study from the University of

Nebraska Medical Center, Omaha and other centres in Nebraska and Minnesota,

United States.

R. O'Dell and colleagues compared the efficacy of the three

combination therapies in 171 rheumatoid arthritis (RA) patients, none of

whom had previously received combinations of any of these drugs. The

patients were randomly assigned to one of the three treatments.

HCQ was given at a dosage of 200 mg twice a day. Patients who were not in

remission had the MTX dosage accelerated from 7.5 mg/week to 17.5 mg/week

and the SSZ dosage from 500 mg twice a day to 1 gm twice a day.

The three combination treatments were all well-tolerated.

Primary end point was the percentage of patients with 20 percent response by

American College of Rheumatology (ACR) criteria at two years.

Patients on the triple combination responded best; 78 percent achieved an

ACR 20 percent response at two years compared with 60 percent of those

treated with MTX and HCQ and 49 percent of those on MTX plus SSZ.

Trends were similar for the ACR 50 percent response, with 55 percent of

those on the drug trio, 40 percent of those on MTX and HCQ and 29 percent of

those on MTX plus SSZ achieving these results at two years.

Similar numbers of patients in each treatment group - totaling 14 people in

all - withdrew from the test because of symptoms possibly related to

medications.

Arthritis & Rheumatism Volume 46, Issue 5, 2002. Pages: 1164-1170.