title: Use of combination therapy in the routine care of patients with rheumatoid arthritis: physician and patient surveys.
abstract: OBJECTIVE
  To describe the utilization of combination therapy in the treatment of rheumatoid arthritis (RA).
  
  
  METHODS
  Review of published articles and abstracts, and patient/physician questionnaire data.
  
  
  RESULTS
  Combination therapy was rarely used in the early 1980s and is now (1999) used for about 25% of RA patients in the US. Physician and patient surveys indicate that methotrexate plus hydroxychloroquine is the most commonly used combination in North America, and physician surveys indicate that methotrexate plus sulfasalazine is the most commonly used combination in Europe. Patient questionnaire data indicate that 13.4% of patients in the US take methotrexate and hydroxychloroquine, and between 11% and 15% of patients with recent onset of RA receive treatment with disease-modifying antirheumatic drug (DMARD) combinations.
  
  
  CONCLUSIONS
  Combination therapy with agents such as hydroxychloroquine and methotrexate is used in up to 25% of RA patients in the US, but the use of "aggressive combination therapy" is unusual. Whether combination therapy as currently practiced is beneficial remains to be determined.
authors.affiliation: National Data Bank for Rheumatic Diseases, Wichita, Kansas 67214, USA. hawley@chp.twsu.edu
authors.forename: D J
authors.initials: DJ
authors.lastname: Hawley
authors.forename: F
authors.initials: F
authors.lastname: Wolfe
authors.forename: T
authors.initials: T
authors.lastname: Pincus
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents