Utility of disease modifying antirheumatic drugs in "sawtooth" strategy. A prospective study of early rheumatoid arthritis patients up to 15 years

作     者：Sokka, T Hannonen, P 

作者机构：Jyvaskyla Cent Hosp Dept Med FIN-40620 Jyvaskyla Finland 

出 版 物：《ANNALS OF THE RHEUMATIC DISEASES》 (风湿病纪事)

年 卷 期：1999年第58卷第10期

页      面：618-622页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：抗风湿药/投药和剂量 抗风湿药/副作用 关节炎 类风湿/药物疗法 用药计划表 药物疗法 联合 随访研究 治疗失败 女(雌)性 人类 男(雄)性 中年人 

摘      要：Objectives-To study long term utility of early continual, and serial use of disease modifying antirheumatic drugs (DMARDs) in early rheumatoid arthritis (RA) in clinical setting. Methods-A total of 135 patients with early RA were treated according to the sawtooth strategy and prospectively followed up to lj years. DMARD survivals as well as reasons for drug terminations were documented and are reported here. Results-During 1401 person years of follow up, a DMARD or a combination of two or several DMARDs (COMBOs) was started 606 times. A total of 528 drug periods were terminated because of inefficacy, adverse effects, remission, and other reasons in respective 270 (51.1%), 149 (28.2%), 32 (6.1%), and 77 (14.6%) cases. Severe drug related adverse events mere rare. The median duration of DMARD periods of individual DMARDs or COMBOs was 10 months ranging from six to 18 months. Not a single DMARD/COMBO stood out favourably from the others with respect to inefficacy, toxicity or drug survival. Conclusion-The use of serial DMARDs/COMBOs was safe even in the long run. Inefficacy rather than toxicity was the leading reason for drug terminations. More powerful drug therapies are needed.