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:11/30/2015)... ... November 30, 2015 , ... The American Society for Clinical Pathology ... World AIDS Day 2015. On Nov. 30, ASCP shared its “Give a minute. Get ... AIDS Day and the importance of getting tested for HIV. , ASCP has asked ...
(Date:11/30/2015)... (PRWEB) , ... November 30, 2015 , ... While powdered ... results in wasted time. Fortunately, an inventor from Chesterfield, Va., has found an easy ... to keep the scoop used to measure powdered contents in a canister or other ...
(Date:11/30/2015)... ... November 30, 2015 , ... ... to its industry-leading suite of automated breast density assessment and enterprise analytics ... meeting, November 29-December 4, 2015 (South Hall booth #2377). Volpara’s quantitative breast ...
(Date:11/30/2015)... ... November 30, 2015 , ... ... for “Value-Based Payer-Provider Partnerships: Three Case Studies,” an upcoming Dec. 8 virtual ... Essentia Health and UCare, MissionPoint Health Partners, and Intel Corp. Leaders from ...
(Date:11/30/2015)... ... November 30, 2015 , ... Insightra Medical, Inc. ... Surgical Mesh technology for soft tissue repair in the US via Insightra’s national ... resorbable surgical mesh intended to support and reinforce soft tissue for 6-9 months ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... HANOVER, N.J. , Nov. 30, 2015  Novartis ... portfolio at the 57 th American Society of ... leukemias, lymphomas and myelomas as well as supportive care, ... in addition to personalized cell therapies. The ASH Annual ... Orlando, Florida . Novartis Oncology . ...
(Date:11/30/2015)... and BOSTON , November 30, 2015 ... develop potential new medicines directed at up to 10 ... --> PFE ) to research and develop ... protein-coupled receptor (GPCR) targets across multiple therapeutic areas. ... drug discovery and development company and wholly-owned subsidiary of ...
(Date:11/30/2015)... 2015 Elbit Imaging Ltd. (TASE, ... today that it was informed by InSightec Ltd. ("InSightec"), that ... has approved its Exablate Neuro system to treat movement, ... --> Insightec,s Exablate Neuro platform is transforming ... two technologies: Focused Ultrasound, which is used to lesion ...
Breaking Medicine Technology: