Combination Therapy Effective for Rheumatoid Arthritis

Treatment of patients with rheumatoid arthritis with a combination of methotrexate (MTX), hydroxychloroquine, and triamcinolone is associated with higher long-term remission rates than methotrexate monotherapy, according to the results of a recent study.

In their study, researchers compared historic cohorts of patients treated with MTX monotherapy (n=297) and combination therapy (n=156) including baseline characteristics and disease activity (DAS28) measurements from the first 3 years of follow-up. The primary outcome of the study was the proportion of patients who reached at least 1 DAS28 <2.6 (remission) during follow-up.
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Overall, more patients on combination therapy reached remission (88.2% vs 72.2% in year 1, 86.5% vs 82.0% in year 2, respectively). Combination treatment was associated with a higher percentage of DAS measurements below 2.6 over the 3 years.

“Combination treatment results in more remissions in the first year of treatment. In the second and third year the remission percentage on monotherapy comes close to combination treatment, at the cost of a 6% higher proportion of patients stepping up to biologicals,” according to the researchers.

—Michael Potts

Reference:

Brunekreef T, Bernelot Moens H. Remission induction with methotrexate step-up therapy versus combination of hydroxychloroquine, methotrexate and triamcinolone: 3 year results Annals of the Rheumatic Diseases. 2017;76:147-148.