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Certain RA patients benefit from combo therapy.

BARCELONA -- Treatment of early rheumatoid arthritis with a combination of disease-modifying antirheumatic drugs slows radiographic progression faster in patients without antibodies against cyclic citrullinated peptide than in those with them, Dr. Markku Korpela reported at the annual European Congress of Rheumatology.

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

Senior Writer
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Title Annotation:Rheumatology; Rheumatoid arthritis
Author:Evans, Jeff
Publication:Internal Medicine News
Article Type:Clinical report
Geographic Code:1USA
Date:Oct 1, 2007
Words:246
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