title: Triple DMARD combination for rheumatoid arthritis resistant to methotrexate and steroid combination: a single-center experience.
abstract: The mainstay of RA treatment is the disease-modifying antirheumatic drugs, and triple DMARD combination is now known to be better than monotherapies. Our aim in this trial was to report our clinical experience with triple DMARD therapy for resistant rheumatoid arthritis. Data of 140 patients with RA resistant to methotrexate and steroid combination were evaluated retrospectively. One hundred and nineteen (85 %) were female, and the median age at diagnosis was 56 (29-82) years. The median time between the diagnosis and beginning of triple therapy was 45.5 (6-564) months. Fifty-two (37.1 %) patients (group 1) on triple therapy protocol achieved remission, but the others (88; 62.9 %) (group 2) did not. The mean DAS28 scores for the study group before triple DMARD therapy and after 12 months under triple DMARD therapy were 4.93 and 3.24, respectively. The DAS28 scores after 12 months for groups 1 and 2 were 2.57 and 3.64. The median follow-up period for patients in group 1 was 60 months (23-118), and the mean DAS28 score at the time of the analysis for group 1 was 2.36. Triple DMARD combination may save one-third of the MTX-resistant RA patients from the serious side effects and the cost of anti-TNF.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Hacettepe University Hospital, 06100 Sihhiye, Ankara, Turkey. metin1721978@yahoo.com
authors.forename: Metin
authors.initials: M
authors.lastname: Isik
authors.forename: Burcin
authors.initials: B
authors.lastname: Halacli
authors.forename: Ozgür
authors.initials: O
authors.lastname: Atmaca
authors.forename: Sezgin
authors.initials: S
authors.lastname: Etgül
authors.forename: Ismail
authors.initials: I
authors.lastname: Doğan
authors.forename: Levent
authors.initials: L
authors.lastname: Kılınç
authors.forename: Meral
authors.initials: M
authors.lastname: Calgüneri
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D008727:Methotrexate