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Drug Therapy for Rheumatoid Arthritis in Adults

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Summary of Benefits: Combination Treatments With Oral DMARDs

The comparative benefits of combination treatments with oral disease-modifying anti-rheumatic drugs (DMARDs) may be summarized as follows:

  • In patients with longstanding active rheumatoid arthritis (RA), combining up to three oral DMARDs (methotrexate [MTX], sulfasalazine, and hydroxychloroquine) produces greater improvements in disease activity than one or two oral DMARDs. The strength of evidence for this finding is moderate.
  • For patients with early RA who have not previously been treated with oral DMARDs, combining oral DMARDs (sulfasalazine and MTX) does not improve symptom response, radiographic progression, or functional capacity more than monotherapy. The strength of evidence for this finding is moderate.