Drug Therapy for Rheumatoid Arthritis in Adults
Summary of Benefits: DMARDs in the Treatment of Patients With Early Rheumatoid Arthritis (1 of 2)
Combination strategies that use corticosteroids plus two or three oral DMARDs are more effective than oral DMARD monotherapy for improving symptom response, disease activity, and functional capacity in patients with rheumatoid arthritis in the short term and reducing radiographic evidence of progression and joint erosion in the longer term (≥1 year).
Combining one oral DMARD with prednisone reduces radiographic progression and joint erosion more than the DMARD alone.
For patients with early RA who have not been treated with methotrexate (MTX):
- Effects on symptom response are similar when MTX is compared with adalimumab or etanercept.
- Effects on functional capacity are similar with MTX and adalimumab.
- Donahue KE, Jonas D, Hansen RA, et al. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; April 2012. AHRQ Publication No. 12-EHC025-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsra.cfm.
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