Navigation Links
Combining Medications Often Best Strategy to Battle Rheumatoid Arthritis
Date:11/19/2007

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 http://www.effectivehealthcare.ahrq.gov.


'/>"/>
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:
*Name:
*Comment:
*Email:
(Date:2/8/2016)... ... 2016 , ... If you are feeling that your clothes are a tad ... to the Center for Disease Control and Prevention (CDC), 34.9% of U.S. adult women ... of cancer, some of the leading causes of preventable death. February is heart ...
(Date:2/8/2016)... ... 2016 , ... Delta Dental of California and its affiliated companies announced today ... Radine, who recently retired as president and CEO of Delta Dental of California and ... the Year , helped lead the effort to raise funds for studies to strengthen ...
(Date:2/8/2016)... ... ... Discover the Rocky Mountain region’s longest running and impressive garden and home show ... to see the most incredible gardens and home improvement experts that attend this amazing ... Center - 700 14th St. Denver CO, is an exciting event that Performance Mobility ...
(Date:2/8/2016)... ... 2016 , ... Guruji Mahendra Kumar Trivedi is offering 3 days of accelerated ... his birthday on February 10th. During this time, people can achieve better health, ... 250,000 people from over 40 different countries as an “ordinary man with an extraordinary ...
(Date:2/7/2016)... Dallas, Texas (PRWEB) , ... February 07, 2016 ... ... its new MyDecision™ program. MyDecision™ empowers employers and organizations with the tools and ... , MyDecision™ combines three elements to cut the cost of providing employee healthcare ...
Breaking Medicine News(10 mins):
(Date:2/8/2016)...  Avista Pharma Solutions ("Avista Pharma") announced today that ... Officer (CFO). Mr. Setzer is a finance and operations ... roles within growing technology and life science companies. Prior ... Director of Finance at INC Research, a publicly traded ... . Previously, Mr. Setzer served as CFO of Expression ...
(Date:2/8/2016)... 8, 2016 Vestagen Technical Textiles, Inc., a ... for healthcare and other demanding applications, today announced it ... He replaces Dale Pfost , PhD, who was ... is also joining Vestagen,s Board of Directors. ... active barrier technologies that combines fluid repellent, antimicrobial and ...
(Date:2/8/2016)... 8, 2016  Astellas Pharma Inc. President and Chief Executive ... James Robinson as president, Americas Operations, for Astellas ... and South America , effective April 1, ... the commercial organization in the United States ... Masao Yoshida , who is retiring in June 2016.  ...
Breaking Medicine Technology: