Drug Therapy for Rheumatoid Arthritis in Adults
Conclusions (3 of 4)
The oral disease-modifying anti-rheumatic drugs (DMARDS), particularly methotrexate (MTX), remain effective first-line treatments for rheumatoid arthritis (RA).
MTX (at a dose of 7.5 to 25 mg per week) and sulfasalazine are similarly effective for patients with early RA, and leflunomide may provide comparable results.
Adding prednisone to treatment with oral DMARDs improves function and may limit radiographic progression, although there is evidence that the combination increases the risks of adverse effects.
For patients with longstanding active disease, two or three oral DMARDs in combination can provide more improvement than monotherapy.
Keywords: rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | methotrexate | prednisone | oral DMARD | biologic DMARD | withdrawal | adverse events | adverse effects
- 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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