Long-term efficacy and toxicity of ciclosporin A in combination with methotrexate in poor prognosis rheumatoid arthritis
Academic Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Leeds, UK
Correspondence to:
Professor P Emery, Academic Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; p.emery@leeds.ac.uk
Accepted 3 August 2008
| The first 150 words of the full text of this article appear below. |
Whereas the optimum therapy for early rheumatoid arthritis (RA) has not been established, there is still interest in combination therapy with existing disease-modifying antirheumatic drugs, due to the cost and toxicity of biological agents. We previously reported a 24-month open-label, randomised study comparing a methotrexate and ciclosporin A combination with sulfasalazine monotherapy in 82 early, poor-prognosis RA patients (n = 40 combination, n = 42 sulfasalazine).1 In the combination arm, first ciclosporin A then methotrexate doses were optimised. After 24 months all patients were treated according to standard clinical care. The aim of this report is to present long-term efficacy and toxicity data.
At 12 months there was no difference in the mean disease activity score based on 28 joints (DAS28; 3.2 for both groups). Mean serum creatinine had increased in both groups (combination 93.6 µmol/l, sulfasalazine 90.6 µmol/l, p = 0.05).1 24-Month data demonstrated no differences between groups for
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