title: A study on the selection of DMARDs for the combination therapy  with adalimumab.
abstract: We evaluated whether or not the effect of adalimumab (ADA) in  combination with the disease-modifying antirheumatic drugs (DMARDs) other than  methotrexate (MTX) is comparable to the ADA+MTX therapy for the treatment of  rheumatoid arthritis (RA). A total of 216 patients with active RA at Kohnan  Kakogawa Hospital and Kobe University Hospital were enrolled. Clinical and  functional outcomes were compared among 4 groups, ADA alone (A group),  ADA + MTX (B group), ADA + MTX + other DMARDs (C group), and ADA + other  DMARDs (D group), and the retention rates of ADA were evaluated with or  without MTX. CRP was significantly decreased from initial measurement at  1 month in all 4 groups, but the continuous efficacy with the statistical  significance at all measurement points were observed only in combination  with MTX (P<0.05), which was reflected by significantly higher retention  rates. Similarly, the disease activities were improved, and particularly  the remission rates (DAS28-CRP < 2.3) of A, B and C groups (>42.9%) were  higher than that of D group (29.4%) at 2 year. An index of patients' basic  activities of daily living, M-HAQ score of A, B and C groups was also better  than that of D group. While, looking at the mean changes of M-HAQ from the  baseline at 2 years, potential effect of other DMARDs on M-HAQ was  also suggested. The results show that ADA + MTX therapy is significantly  superior than ADA + other DMARDs in ameliorating RA.
authors.affiliation: Department of Medicine, Division of Rheumatology,  Kobe University Graduate School of Medicine and the Center for Rheumatic Disease.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Tanaka
authors.forename: Kazuko
authors.initials: K
authors.lastname: Shiozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Hashiramoto
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D002097:C-Reactive Protein; D000068879:Adalimumab; D008727:Methotrexate