title: Classic disease modifying anti-rheumatic drugs (DMARDs) in combination with infliximab. The Finnish experience.
abstract: To assess the performance of infliximab in a clinical setting, 364 rheumatoid arthritis (RA) patients from the National Register of Biological Treatment in Finland (ROB-FIN) were analysed. Corticosteroid usage and dose diminished (p<0.05 and 0.001, respectively) in patients on infliximab, of whom 51% also used one, 28% two and 16% three other concomitant DMARDs. A 34% of the RA patients used methotrexate+/-corticosteroids without any other DMARD. Methotrexate was most frequently used with sulphasalazine and/or hydroxychloroquine. Non-methotrexate patients most frequently used leflunomide or azathioprine combined with corticosteroids. The clinical effect of these combinations was similar to that of infliximab with methotrexate alone. The results indicate that infliximab can be used together with other DMARDs than methotrexate alone, quite according to the philosophy of the combination drug therapy, as the effectiveness is as good as or even slightly better than that of methotrexate and infliximab.
authors.affiliation: Department of Internal Medicine, Helsinki University Central Hospital, Haartmanink. 4, 00290, Helsinki, Finland. dan.nordstrom@hus.fi
authors.forename: D C
authors.initials: DC
authors.lastname: Nordström
authors.forename: L
authors.initials: L
authors.lastname: Konttinen
authors.forename: M
authors.initials: M
authors.lastname: Korpela
authors.forename: T
authors.initials: T
authors.lastname: Tiippana-Kinnunen
authors.forename: K
authors.initials: K
authors.lastname: Eklund
authors.forename: S
authors.initials: S
authors.lastname: Forsberg
authors.forename: K
authors.initials: K
authors.lastname: Ilva
authors.forename: O
authors.initials: O
authors.lastname: Kaipiainen-Seppänen
authors.forename: T
authors.initials: T
authors.lastname: Malmi
authors.forename: T
authors.initials: T
authors.lastname: Ylä-Kerttula
authors.forename: V
authors.initials: V
authors.lastname: Honkanen
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D000069285:Infliximab; D008727:Methotrexate