Certain RA patients benefit from combo therapy.
In a subset of patients from the randomized Finnish RA Combination Therapy (FIN-RACo) trial whose anti-cyclic citrullinated peptide (CCP) status was known, 69 patients were treated initially with a combination of methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone; another 60 patients were treated with sulfasalazine, with or without prednisolone. The DMARD and prednisolone treatments were allowed to change after 2 years, according to Dr. Korpela, a rheumatologist at Tampere (Finland) University Hospital.
Dr. Korpela and his colleagues found that a combination of DMARDs could significantly slow radiographic signs of RA progression (as defined by the Larsen score in hands and feet) in the absence of anti-CCP antibodies, but treatment with a single DMARD could not. Radiographic RA progression occurred at similar rates in anti-CCP positive and -negative patients when only one DMARD was used.
"This means that patients without CCP antibodies should be treated aggressively," Dr. Korpela said in an interview during a poster presentation at the congress.
Of the 129 patients, 92 (71%) tested positive for anti-CCP antibodies. Compared with anti-CCP-negative patients, those who tested positive for the antibodies also were significantly more likely to test positive for rheumatoid factor (83% vs. 22%) or erosive disease at baseline (54% vs. 22%).
BY JEFF EVANS
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|Title Annotation:||Rheumatology; Rheumatoid arthritis|
|Publication:||Internal Medicine News|
|Article Type:||Clinical report|
|Date:||Oct 1, 2007|
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