Background It is known that the early period of rheumatoid arthritis (RA) has a critical role in the development and progression of immune inflammation. Allocation of early RA is due to the need for timely appointment of basic anti-inflammatory drugs to prevent the development of destructive changes in the joints and improve its current forecast. We have proposed a combination of two basic drugs for the treatment of RA, methotrexate (MTX) and leflunomide (LF). While this combination, we proceeded from the basic principles of combination therapy: each of the drugs has an independent clinical effect in early RA, the drugs have different mechanisms of action and different spectrum of side effects.
Objectives Investigating of clinical efficacy of combination therapy with MT and LF in patients with RA in its early stages
Methods We observed 80 patients with early RA, 50 patients of them were women and 30 patients were male. The age of patients ranged from 24 up to 42 years old (31,7±7,6), the duration of illness was 6 months. Activity of RA was corresponded to the II degree (DAS 28 <4.7) in 48 patients, III degree (DAS28>5,1) was in 32 patients. 1st group consisted of 40 patients and the 2nd group involved 40 patients. Patients in 1st group received combination therapy with LF in doses 20 mg/day and MT in doses 7.5 mg/week. 2nd group received just MT as a single basic anti-inflammatory drug in doses 7.5 mg/week. In order to improve portability of MT was administered to all patients folic acid in doses 1.2 mg/day, 5 days in a week. The efficiency of the intervention was evaluated after 6 months by reducing of the final value of the indicator of inflammatory activity.
Results The results of observation of patients for 6 months were showed that, combination therapy with MT and LF provides a quick and pronounced clinical effect in patients in the early stages of RA. Patients of 1st group according to criteria ACR 50- 70% improvement was achieved in 50% of patients, while figure of all indicators of patients in 2nd group was 33.4%. During the treatment was indicated improvement of laboratory parameters of disease activity of RA in both groups, features of activity of 1st group were decreased up to (DAS28 =2,9), signs of 2nd group were (DAS28 =3,6). However, there were 26% of cases of clinical remission of the disease in patients of 1st group than patients of 2nd group. Known side effects of combination therapy with MT and LF in most cases have not been severe, reversible and demanded the abolition of drugs in rare (11.2%) cases.
Conclusions Combined basic therapy of patients in the early stages of RA with LF and MT has more efficiency than mono therapy.
Disclosure of Interest None declared