Abstract |
Although etanercept (ETN) is effective when used in monotherapy for the treatment of rheumatoid arthritis (RA), ETN/ methotrexate (MTX) combination therapy is more efficacious. However, some patients show MTX intolerance; these patients may develop adverse events (AEs) or have risk factors for AEs. There is limited published information regarding the efficacy of combination therapy involving ETN and disease-modifying antirheumatic drugs other than MTX. Therefore, we evaluated the effects of combination therapy with ETN and salazosulfapyridine (SASP) and/or bucillamine (Bc), a D: -penicillamine analogue, in MTX-intolerant RA patients. Indices of RA activity, including disease activity score in 28 joints (DAS28), were retrospectively analyzed over a 48-week period in 66 patients treated with ETN. Treatment efficacy was compared in the following 4 major treatment groups: ETN monotherapy, ETN + MTX, ETN + SASP, and ETN + SASP + Bc. Although intergroup differences in the percent change of DAS were not statistically significant, ETN + SASP + Bc seemed to be more effective than ETN monotherapy, and the efficacy of ETN + SASP + Bc was comparable to that of ETN + MTX according to the European League Against Rheumatism (EULAR) improvement ratings. These results suggest that ETN + SASP + Bc combination therapy may be a viable option for RA treatment in patients in whom MTX cannot be used.
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Authors | Yoshinobu Koyama, Hirokazu Shiraishi, Toshiyuki Ohta, Ayumi Uchino |
Journal | Modern rheumatology
(Mod Rheumatol)
Vol. 22
Issue 1
Pg. 100-8
(Feb 2012)
ISSN: 1439-7609 [Electronic] England |
PMID | 21706263
(Publication Type: Journal Article)
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Chemical References |
- Antirheumatic Agents
- Glucocorticoids
- Immunoglobulin G
- Receptors, Tumor Necrosis Factor
- Sulfasalazine
- Cysteine
- Etanercept
- bucillamine
- Methotrexate
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(diagnosis, drug therapy, physiopathology)
- Cysteine
(analogs & derivatives, therapeutic use)
- Drug Substitution
- Drug Therapy, Combination
- Etanercept
- Female
- Glucocorticoids
(therapeutic use)
- Humans
- Immunoglobulin G
(therapeutic use)
- Joints
(drug effects, physiopathology)
- Male
- Methotrexate
(adverse effects)
- Middle Aged
- Pain Measurement
- Receptors, Tumor Necrosis Factor
(therapeutic use)
- Recovery of Function
- Retrospective Studies
- Severity of Illness Index
- Sulfasalazine
(therapeutic use)
- Treatment Failure
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