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 | Combination DMARD therapy for rheumatoid arthritis. Full or low DMARD doses? |
| Author's reply |
Combination DMARD therapy for rheumatoid arthritis. Full or low DMARD doses?
| The first 150 words of the full text of this article appear below. |
We read with great interest the paper by O'Dell.1
We would like to offer some comments on it. Although we strongly
believe in the rationale of the author, we feel that as clinicians our options should be based on clear cut data when treating patients with
erosive progressive rheumatoid disease. In our clinical practice, in
active and severe diseases, we try to optimise any treatment by using
the highest doses of both non-steroidal anti-inflammatory drugs and
disease modifying antirheumatic drugs (DMARDs), compatible with an
acceptable risk of toxicity. According to the medical literature, in
rheumatoid arthritis (RA) the highest doses of OH-chloroquine (OH-C)
are 6 mg/kg/day, of methotrexate (MTX) 17.5-20 mg/week, and of
sulphasalazine 3 g/day.2-4 Poor or inadequate responses
can be assessed only when these amounts are reached. In the study by
O'Dell,5 three groups of patients were studied, one
receiving full doses of MTX, one a combination of full doses
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