Navigation Links
Combining Medications Often Best Strategy to Battle Rheumatoid Arthritis

ROCKVILLE, Md., Nov. 16 /PRNewswire-USNewswire/ -- For patients with rheumatoid arthritis, combining one well-known, lower cost synthetic drug with one of six biologic medications often works best to reduce joint swelling or tenderness, according to a new report funded by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. An article based on the report will be posted on-line Monday in the Annals of Internal Medicine.

Researchers reviewed published evidence to compare the benefits and harms of three classes of medications: synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs and corticosteroids. Synthetic DMARDs include hydroxychloroquine, leflunomide, methotrexate and sulfasalazine; biologic DMARDs include abatacept, adalimumab, anakinra, etanercept, infliximab and rituximab; and corticosteroids include drugs such as prednisone.

The report concluded that combining methotrexate, a synthetic DMARD, with one of the biologic DMARDs works better than using methotrexate or a biologic DMARD alone. The report also found that methotrexate works as effectively as the biologic DMARDs adalimumab and etanercept for patients who have early rheumatoid arthritis. Adalimumab and etanercept, however, show better short-term results as measured by X-rays of joints. The report also emphasized that biologic DMARDs and methotrexate increase the risk of serious infection, including a reoccurrence of tuberculosis.

"Rheumatoid arthritis is a painful, degenerative disease that affects people of all ages and can profoundly impact quality of life," said AHRQ Director Carolyn M. Clancy, M.D. "This report establishes a clear, unbiased summary of what is known about current treatments. It also identifies areas where more research is needed."

About 2 million Americans have rheumatoid arthritis, a long-term illness that causes joint and tissue inflammation. Rheumatoid arthritis is an autoimmune disease, meaning that the body confuses healthy tissue for foreign substances and attacks itself. The cause is unknown. The disease often begins with fatigue, morning stiffness, weakness and muscle aches. Eventually, joint pain appears. Pain may affect the wrists, knees, elbows, fingers, toes, ankles or neck. Other symptoms may include anemia, eye burning, limited range of motion, skin redness and swollen glands. Joint destruction may occur within 1 to 2 years after the disease appears. Some cases cause deformities. Treatment typically begins with medications but may include physical therapy and surgery.

Among other findings in the report:

-- Combining prednisone with the synthetic DMARD hydroxychloroquine, methotrexate or sulfasalazine works better than using only a synthetic DMARD to reduce joint swelling and tenderness and to improve function.

-- No meaningful clinical differences can be found between methotrexate and either leflunomide or sulfasalazine.

-- Combining the synthetic DMARDs methotrexate and sulfasalazine is no more effective than using just one of the medications for patients with early rheumatoid arthritis.

-- Not enough evidence exists to determine whether combining two biologic DMARDs is more effective than using one biologic DMARD.

-- About 17 of every 1,000 people taking a biologic DMARD for 3 to 12 months have a serious infection. Combining two biologic DMARDs can increase the risk.

-- Among biologic DMARDs, rates of painful injection site reactions are more common for anakinra (67 percent) than for etanercept (22 percent) or adalimumab (18 percent).

-- More long-term research is needed on rheumatoid arthritis medications, including how the outcomes of these drugs vary among patients with different health conditions and demographic characteristics. More comparative studies on various combinations of drugs are critical. Also important is investigating whether taking the medications earlier (especially biologic DMARDs) is better for long-term outcomes.

The report, Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in Adults, was authored by the AHRQ-funded RTI International-University of North Carolina Evidence-based Practice Center in Chapel Hill, NC. It is the newest analysis from AHRQ's Effective Health Care Program. That program represents an important federal effort to compare alternative treatments for significant health conditions and make the findings public. The program is intended to help patients, doctors, nurses and others choose the most effective treatments. Information on the program, including full reports and plain-language summary guides, can be found at

SOURCE Agency for Healthcare Research & Quality
Copyright©2007 PR Newswire.
All rights reserved

Related medicine news :

1. AHRQ and FDA to Collaborate in Largest Study Ever of Possible Heart Risks with ADHD Medications
2. Diet and medications may assist prevention of prostate cancer
3. Cautious Optimism for New Alzheimers Medications, Reports the Harvard Mental Health Letter
4. Patients cant recall their medications to tell doctors
5. The American Pharmacists Association Supports Consumer Education About OTC Medications
6. For Health Info, Women Often Turn to the Web
7. Doctors Often Miss High Blood Pressure in Kids
8. One Surgery Often Enough for Peritonitis
9. Gene Studies of Male-Female Differences Often Flawed
10. Melanoma Diagnosis Often Delayed for Rural Poor
11. Drinking Often Spurs Move to Poorer Neighborhoods
Post Your Comments:
(Date:10/13/2017)... Rock, AR (PRWEB) , ... October 13, 2017 ... ... firm with locations throughout Arkansas that offers insurance and financial preparation services, is ... benefit the Rock City Rescue organization. , Rock City Rescue is a locally ...
(Date:10/13/2017)... ... ... While it’s often important to take certain medications during the night, finding ... identified a solution. , She developed a prototype for MOTION LIGHT-UP PILL BOX to ... the need to turn on a light when taking medication during the night, allowing ...
(Date:10/13/2017)... ... October 13, 2017 , ... The International ... promote standards of excellence for the field of eating disorders, announces the opening ... 25, 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. ...
(Date:10/13/2017)... , ... October 13, 2017 ... ... of Pharmacy (SOP) alumni Hannah Randall, PharmD ‘17, and Jennifer Huggins, PharmD ... on guideline updates for the primary prevention of cardiovascular diseases during the ...
(Date:10/13/2017)... CT (PRWEB) , ... October 13, 2017 , ... ... long-term care services, staged a mock evacuation of the facility as part of a ... Shelton Fire Department, Echo Hose EMS and Shelton City Emergency Manager, as well as ...
Breaking Medicine News(10 mins):
(Date:9/28/2017)... 28, 2017 Hill-Rom Holdings, Inc. (NYSE: HRC), ... call and webcast on Friday, November 3, 2017, beginning ... ending at approximately 8:30 a.m. (CDT) / 9:30 a.m. ... 2017 financial performance and guidance for 2018, Hill-Rom executives ... enhance operational performance, and long-range financial outlook through 2020. ...
(Date:9/25/2017)... R.I. , Sept. 25, 2017  EpiVax, ... assessment, vaccine design, and immune-engineering today announced the ... on the development of personalized therapeutic cancer vaccines. ... has provided exclusive access to enabling technologies to ... Eng., MBA will lead EpiVax Oncology as Chief ...
(Date:9/19/2017)... ZirMed Inc ., a recognized leader in cloud-based revenue cycle ... ranked #1 by its users for the seventh consecutive year ... ZirMed was recognized as the top-ranked end-to-end revenue cycle management ... 200 beds and holds one of the longest #1 ranking ... ...
Breaking Medicine Technology: