Combo Tx May Improve Disease Control for Some in Early RA

man hands gout arthritis
man hands gout arthritis
Improved disease control, remission, functional capacity for TNF or non-TNF plus methotrexate

HealthDay News – For patients with early rheumatoid arthritis (RA) and high disease activity, the combination of a tumor necrosis factor (TNF) or non-TNF biologic with methotrexate improves disease control, remission, and functional capacity compared with monotherapy, according to a review published online August 6 in the Journal of General Internal Medicine.

Katrina E. Donahue, MD, MPH, from the University of North Carolina in Chapel Hill, and colleagues performed qualitative and network meta-analyses to compare the benefits and harms of biologic drug therapies for adults within 1 year of diagnosis of early RA. Data were included from 22 eligible studies with 9934 participants.

The researchers found that compared with monotherapy of either methotrexate or a biologic, combination therapy with TNF or non-TNF biologics plus methotrexate improved disease control, remission, and functional capacity. Compared with methotrexate monotherapy, network analyses identified higher American College of Rheumatology 50% improvement for combination therapy of biologic plus methotrexate (relative risk range, 1.20 to 1.57). Treatment discontinuation rates due to adverse events or serious adverse events did not differ significantly.

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“Future research directions include comparisons of patients with different degrees of disease activity or poor prognostic factors and longer-term effects,” the authors write. “Studies with longer treatment periods and follow-up of five years or longer would provide better information on long-term effectiveness, adherence, and adverse events. They would also yield insights as to whether starting with a biologic improves long-term prognosis of RA.”

Abstract/Full Text