New strategy for rheumatoid arthritis is effective, safe and cheap
A new drug combination for rheumatoid arthritis treats the disease just as well as other intensive treatment strategies but with less medication and fewer side effects at a significantly lower cost, experts claim in the Annals of Rheumatic Diseases.
A research team looked at various therapies for early rheumatoid arthritis, with the aim of finding the best combination and dose of three commonly prescribed antirheumatic drugs (methotrexate, sulfasalazine and leflunomide) in combination with glucocorticoids (steroid hormones).
A total of 290 people with early rheumatoid arthritis were split into three treatment groups. Each group received a different combination therapy: COBRA Classic (methotrexate, sulfasalazine and a high first dose of glucocorticoids), COBRA Slim (methotrexate and a moderate dose of glucocorticoids) or COBRA Avant-Garde (methotrexate, leflunomide and a moderate dose of glucocorticoids).
All three strategies were successful as disease remission was achieved in 7 in 10 patients after 16 weeks of treatment. But the strategies varied significantly when it came to side effects.
The COBRA Slim strategy (that involves the least amount of medication) had half as many side effects as the two other strategies – and was just as effective. It is also less complicated so is easier to implement in daily practice.
The research team says that a broader use of this strategy would lead to higher remission rates in the global early rheumatoid arthritis population and would probably reduce the need for expensive second-line antirheumatic treatment.
“One surprising finding in the study was the high remission values recorded for all of the applied intensive treatment strategies, which were unprecedented internationally,” says Dr Diederik De Cock, who is involved in the work. “Methotrexate is very affordable, as are steroids. At the moment, rheumatoid arthritis treatment is not yet adequately standardized in Belgium, and this leads to treatment inefficiencies. As a result, more patients require expensive second-line antirheumatic therapies known as biologicals, which can cost up to 15,000 euros per year. By comparison, the COBRA Slim strategy costs less than 1,000 euros. In other words, we can treat up to 15 patients for the same price as a year of treatment with a biological.”
Click here to read the original research.
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Image credit Toby Fruge
