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AB0426 The efficacy of the triple combination therapy with methotrexate, leflunomide and methylprednisolone in rheumatoid arthritis
  1. L Groppa1,
  2. E Russu1,
  3. L Chislari1,
  4. O Bujor2
  1. 1Rheumatology and Nephrology, State University of Medicine and Pharmacy “Nicolae Testemitanu”
  2. 2Arthrology, Republican Clinical Hospital, Chisinau, Moldova, Republic of


Background The RA modern treatment approaches are based on “aggressive therapy”, which aims at suppressing autoimmune inflammation and prevent joint destructionsat the early stages of the disease.

Objectives To evaluate the effectiveness and tolerability of the triple combination therapy with methotrexate, leflunomide and methylprednisolone in patients with rheumatoid arthritis.

Methods The study included 150 patients with rheumatoid arthritis. As a result of randomization, 50 patients received triple combination therapy (methotrexate +methylprednisolone+leflunomide), 50 patients with monotherapy with methotrexate, leflunomide 50 others. As a result all patient groups were comparable after all clinical and demographic indices.

Results Our results showed that triple therapy is very effective in treating patients with RA. A significant improvement on the criteria of the AAR (ACR>50) at the end of the study was observed in most patients receiving methotrexate, leflunomide and methylprednisolone. This is confirmed statistically and clinically positive dynamics significantly in almost all indicators used of efficacy (pain, stiffness, number of tender and swollen joints, the activity of AR, the value VSH index functional HAQ) In addition, the use of triple therapy decreased average dose simultaneous use of glucocorticosteroids daily (from 5.0 to 2.5 mg) and 76% of patients canceled anti-inflammatory non-steroid drugs.

Conclusions After randomized trial data lasting 24 months based triple therapy (methotrexate, leflunomide and methylprednisolone) was highly effective in patients with high RA activity. A significant improvement according to the criteria of ACR (ACR>50) was obtained in 31 of 39 patients (79.48%), including the nine patients (23.07%) had developed clinical remission.

Administration of the basic triple therapy was characterized by a significant clinical effect ACR stability of>50. It was maintained during not less than 15 months of research in 28 (90.32%) of patients who received this treatment and only 3 of 11 (27.27%) patients who received methotrexate alone group and 8 in 10 (80%) who administered LF (p=0.039). Evidence recovery (ACR>50), as well as clinical remission was kept stable in all 28 patients that triple therapy was extended after the ending of basic research.

Disclosure of Interest None declared

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