Drug Combination Eases Rheumatoid Arthritis

2 Drugs May Be Better Than 1 for Rheumatoid Arthritis Treatment

From the WebMD Archives

Feb. 26, 2004 -- A combination of two drugs commonly used separately to treat rheumatoid arthritis may be more effective in fighting the potentially crippling disease than using either drug alone.

A new study showed that a combination therapy of Enbrel (etanercept) and methotrexate provided better relief from symptoms than individual treatment with the drugs.

The drug combination also led to complete remission of the disease in more than twice as many patients compared with those treated with either drug alone.

Rheumatoid arthritis affects about 1% of the population and causes gradual deterioration of the joints. Researchers say that early treatment with combination drug therapy may help prevent destruction of the joints and slow the progression of the disease.

Rheumatoid Arthritis Drugs Better Together

In the study, published in the Feb. 28 issue of The Lancet, researchers compared the effectiveness of treatment with Enbrel (given twice a week by injection) or weekly oral methotrexate alone to treatment with both drugs in 682 people with active rheumatoid arthritis. The effects of the three different treatments were assessed using standards set by the American College of Rheumatology.

After six months of treatment, the study showed that the drug combination provided better relief from symptoms than the individual therapies. After one year, 35% of patients given the combination therapy experienced a complete remission of their disease compared with 16% of those given Enbrel and 13% given methotrexate.

The study also showed that the combination therapy was more effective at preventing joint destruction and erosion, as demonstrated by X-rays.

Researchers say it's the first time a treatment has been shown to improve joint erosion in people with established rheumatoid arthritis. They say the finding suggests that repair of joints damaged by the disease may be possible.

In an editorial that accompanies the study, Armin Schnabel of the Klinik für Internistische Rheumatologie und Klinische Immunologie in Bad Wildbad, Germany says many patients benefit from several drug combinations that modify the progression of the disease. Much as in single drug therapy, combination therapy is not always universally effective and leaves a sizable number of patients with active inflammation.

Schnabel says the next generation of studies should target people in the early stages of rheumatoid arthritis in order to see if there is a critical window of opportunity during which these combined therapies might offer the greatest benefits.

WebMD Health News Reviewed by Brunilda Nazario, MD on February 26, 2004


SOURCE: Klareskog, L. The Lancet, Feb. 28, 2004; vol 363: pp 675-681.

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