Putting rheumatoid arthritis patients on additional oral disease-modifying drugs when they show poor response to methotrexate in the disease's early stages did not work as well as adding infliximab (Remicade) in an open-label, randomized trial.
One-quarter of recently-diagnosed RA patients who took sulfasalazine and hydroxychloroquine in addition to methotrexate (after the latter drug alone failed to induce remission), achieved "good responses" by the standards of the European League Against Rheumatism (EULAR), compared with 39% assigned to infliximab as an add-on to methotrexate (P=0.016).
The results, reported by Ronald van Vollenhoven, MD, of Karolinska University Hospital in Stockholm, and colleagues appear in the Aug. 8 issue of The Lancet.
Patients on infliximab also responded significantly better according to ACR20 and ACR50 criteria, reflecting 20% and 50% improvement, respectively, on criteria set by the American College of Rheumatology.
"In patients with early rheumatoid arthritis in whom methotrexate treatment failed, addition of a tumor necrosis factor antagonist to methotrexate monotherapy is clinically superior to addition of conventional disease-modifying antirheumatic drugs," the researchers concluded.
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