Extended reports
Effect of resumption of second line drugs in patients with
rheumatoid arthritis that flared up after treatment discontinuation
a Departments of Rheumatology
, b and
Medical Statistics , c University
Hospital Leiden, the NetherlandsDepartment of
Rheumatology of Free University Hospital Amsterdam, the Netherlands
Correspondence to: Dr S ten Wolde, Department of Rheumatology, University Hospital Leiden, Building 1, C4R, PO Box 9600, 2300 RC Leiden, the Netherlands.
Accepted for publication 14 January 1997
OBJECTIVE
To assess the effect of resumption of
second line drugs in patients with rheumatoid arthritis (RA) that
flared after treatment discontinuation.
METHODSRA patients were studied whose RA flared
up after discontinuation of second line treatment while being in
remission and who received a second course of the drug. Disease
activity parameters were prospectively assessed at the time of
treatment discontinuation, during the period when the disease flared
up, and three months thereafter. Furthermore the medical charts were
reviewed at 12 months after treatment resumption.
RESULTSThere were 51 patients included in the
study: 25 patients treated with antimalarial drugs, 10 with parenteral
gold, four with d-penicillamine, eight with sulphasalazine, two with
azathioprine, and two with methotrexate. Disease activity parameters
showed significant improvement within three months of treatment
resumption, but remained significantly worse when compared with that
measured before treatment discontinuation. Within three months 47% of
the patients fulfilled 20% response criteria. Disease activity 12 months after treatment resumption was considered to be absent in 35%,
mild in 43%, and moderate or active in 22% of the patients. In four
(8%) patients the resumed treatment was stopped because of lack of
efficacy. Side effects were recorded in four patients, which did not
result in treatment discontinuation.
CONCLUSIONSResumption of second line drugs in
RA patients whose disease flared up after discontinuation of treatment
is effective and safe in most patients. Half of the patients responded
within three months after resumption of the second line drug.
© 1997 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Smolen, J S, Han, C, van der Heijde, D M F M, Emery, P, Bathon, J M, Keystone, E, Maini, R N, Kalden, J R, Aletaha, D, Baker, D, Han, J, Bala, M, St Clair, E W, for the Active-Controlled Study of Patients Receiv,
(2009). Radiographic changes in rheumatoid arthritis patients attaining different disease activity states with methotrexate monotherapy and infliximab plus methotrexate: the impacts of remission and tumour necrosis factor blockade. Ann Rheum Dis
68: 823-827
[Abstract] [Full Text] -
van der Heijden, J, de Jong, M C, Dijkmans, B A C, Lems, W F, Oerlemans, R, Kathmann, I, Scheffer, G L, Scheper, R J, Assaraf, Y G, Jansen, G
(2004). Acquired resistance of human T cells to sulfasalazine: stability of the resistant phenotype and sensitivity to non-related DMARDs. Ann Rheum Dis
63: 131-137
[Abstract] [Full Text] -
Sander, O., Herborn, G., Bock, E., Rau, R.
(1999). Prospective six year follow up of patients withdrawn from a randomised study comparing parenteral gold salt and methotrexate. Ann Rheum Dis
58: 281-287
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Immunology (including allergy)
-
Connective tissue disease
-
Degenerative joint disease
-
Musculoskeletal syndromes
- Rheumatoid arthritis
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
