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:11/25/2015)... ... 2015 , ... Brillianteen, McGaw YMCA’s student-produced musical show, will ... Anniversary Brillianteen Revue, scheduled for March 4-6, 2016. Auditions for this final production ... been a treasured tradition for numerous families in the Evanston community. Over the ...
(Date:11/25/2015)... ... November 25, 2015 , ... Today, Mothers Against ... nation’s roadways has dropped below 10,000 for the first time since 2011. In 2014, ... , According to data released by the National Highway Traffic Safety Administration (NHTSA), 32,675 ...
(Date:11/25/2015)... , ... November 25, 2015 , ... ... cancer, I found that regular bras were incredibly uncomfortable," said an inventor from ... specialized bra." , She developed the patent-pending RECOVERY BRA for added comfort and ...
(Date:11/25/2015)... , ... November 25, 2015 , ... Many people know ... fuzzy-headedness, weight gain, cold hands, and dry skin. But many people who find their ... and exercise regimen instead of their thyroid, especially if they don’t have any of ...
(Date:11/25/2015)... CA (PRWEB) , ... November 25, 2015 , ... Students ... prizes were awarded to winners of the Create Real Impact awards. California Casualty ... expression to help stem the tide of distracted and reckless driving, the number one ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015  Amgen (NASDAQ: AMGN ... Application (BLA) with the United States ... 501, a biosimilar candidate to Humira ® (adalimumab). ... application submitted to the FDA and represents Amgen,s first ... Sean E. Harper , M.D., executive vice president of ...
(Date:11/25/2015)... 2015 On Tuesday, November 24, 2015, ... against Wright Medical Technology, Inc. for product liability ... hip implant device, awarded $11 million in favor ... trial and three days of deliberations, the jury ... defectively designed and unreasonably dangerous, and that Wright ...
(Date:11/25/2015)... Allergan plc (NYSE: AGN ) today announced that it ... State Attorney General,s Office to end the litigation ... with the Attorney General over the decision of Forest Laboratories, ... the now generic version of memantine immediate release tablets.  Under ... its counterclaims against New York , and ...
Breaking Medicine Technology: