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COMPARATIVE EFFICIENCY AND TOLERABILITY OF CURRENT THERAPIES FOR EARLY RHEUMATOID ARTHRITIS

https://doi.org/10.14412/1995-4484-2015-162-168

Abstract

Objective: to compare the efficiency and safety of four treatment regimens using methotrexate (MT),  leflunomide (LEF),  and a combination  of MT and glucocorticoids  (GC)  for early rheumatoid  arthritis (RA) (disease duration <2 years).

Subjects and methods. 141 patients with early RA (of them there were 122 women; mean age 51 years; mean disease duration  7.8 months;  mean DAS28 6.0) were randomized  to 4 treatment groups: 1) MT 10–20 mg/week (n = 35); 2) MT 10–20 mg/week + oral GC equivalent to 10 mg/day of prednisolone  (n = 34); 3) MT 10–20 mg/week + oral CG + single intravenous administration of methylprednisolone (MP) 1000 mg at baseline (n = 35); 4) LEF 20 mg/day (n = 37). The patients were matched for main clinical and demographic  characteristics. The duration of treatment was 1 year. Its efficiency was evaluated according to the European  League Against Rheumatism (EULAR)  criteria.

Results. 125 patients completed one-year treatment. At this time, 11.4% of the patients achieved remission (DAS28 <2.6) in the MT group, 37.5% in the MT+GC group, 29.4% in the MT+GC+MP group, and 16.2% in the LEF group. Adverse events, mainly of mild intensity, were recorded in 9 patients in each MT group. A total of 7 patients had to discontinue treatment because of its inefficiency.

Conclusion. All the four therapy regimens demonstrated a significant efficiency in patients with early RA; the total remission rate was 24%. The combination  of MT and GC produced the most pronounced effect. The tolerability of treatment was good in all groups.

About the Authors

E. V. Fedorenko
Научноисследовательский институт ревматологии им. В.А. Насоновой, Москва
Russian Federation

Contact: Evgenia Fedorenko; evfedorenko1@gmail.com



G. V. Lukina
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


Ya. A. Sigidin
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


E. L. Luchikhina
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


D. E. Karateev
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


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Review

For citations:


Fedorenko E.V., Lukina G.V., Sigidin Ya.A., Luchikhina E.L., Karateev D.E. COMPARATIVE EFFICIENCY AND TOLERABILITY OF CURRENT THERAPIES FOR EARLY RHEUMATOID ARTHRITIS. Rheumatology Science and Practice. 2015;53(2):162-168. (In Russ.) https://doi.org/10.14412/1995-4484-2015-162-168

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)