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Drug Therapy for Rheumatoid Arthritis in Adults
Authors: John I. Gomez, MD
Summary of Benefits: Comparative Effectiveness of Oral DMARDs for Rheumatoid Arthritis
The comparative benefits of oral disease-modifying anti-rheumatic drugs (DMARDs) may be summarized as follows:
- Leflunomide and methotrexate (MTX; 7.5 to 25 mg/week) have similar effects on symptom response, radiographic change, and functional capacity. The strength of evidence for this finding is low.
- Leflunomide may be superior to sulfasalazine for improving functional capacity. The strength of evidence for this finding is low.
- Sulfasalazine and MTX (7.5 to 25 mg/week) have similar effects on symptoms, disease activity, functional capacity, and limiting radiographic changes (in patients with rheumatoid arthritis for <3 years). The strength of evidence for this finding is moderate.
Keywords: rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | biologic DMARD | oral DMARD | nonbiologic DMARD | early RA | methotrexate | sulfasalazine | leflunomide | disease activity | symptom response | radiographic progression | functional capacity
- 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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