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Long-term efficacy and toxicity of ciclosporin A in combination with methotrexate in poor prognosis rheumatoid arthritis
  1. V Bejarano,
  2. P G Conaghan,
  3. S M Proudman,
  4. M H Buch,
  5. A K Brown,
  6. P Emery
  1. Academic Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Leeds, UK
  1. Professor P Emery, Academic Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; p.emery{at}leeds.ac.uk

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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 …

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