Longterm maintenance therapy with disease modifying antirheumatic drugs.

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J Rheumatol Suppl 2002 Nov;66:38-43

Longterm maintenance therapy with disease modifying antirheumatic drugs.

Capell H.

Centre for Rheumatic Disease, Royal Infirmary, Glasgow, Scotland.

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Longterm safety and efficacy of disease modifying antirheumatic drugs

(DMARD) have been challenging to assess. There are few studies that have

evaluated patient outcome beyond 5 years. As patients may receive several

DMARD over the course of their disease a long with nonsteroidal

antiinflammatory drugs, corticosteroids, and other drugs for comorbidities,

it is difficult to design and implement a trial to define a specific drug's

longterm effect. Based on the findings of several key studies, however, it

does appear that DMARD are safe when taken longterm, and that they are more

likely to be discontinued because of inefficacy than toxicity. Although

DMARD are often discontinued because of lack of efficacy, 12 year data

suggest that DMARD can provide benefit over this period. The toxicity

profiles vary significantly between DMARD. In addition, the time during

therapy when the majority of these adverse effects most frequently appear is

DMARD-specific. Prospective studies are needed to further clarify longterm

safety and efficacy of the newer DMARD.

PMID: 12435167 [PubMed - in process]