Triple Oral Therapy Versus Antitumor Necrosis Factor Plus Methotrexate (MTX) in Patients with Rheumatoid Arthritis and Inadequate Response to MTX: A Systematic Literature Review
| العنوان: | Triple Oral Therapy Versus Antitumor Necrosis Factor Plus Methotrexate (MTX) in Patients with Rheumatoid Arthritis and Inadequate Response to MTX: A Systematic Literature Review |
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| المؤلفون: | Jacques Morel, Bernard Combe, Michel De Bandt, J. Mary, Cédric Lukas |
| المساهمون: | Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CHU de la Martinique, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) |
| المصدر: | Journal of Rheumatology Journal of Rheumatology, Journal of Rheumatology Publishing Company Limited, 2017, 44 (6), pp.773-779. ⟨10.3899/jrheum.160643⟩ Journal of Rheumatology, Journal of Rheumatology Publishing Company Limited, 2017, 44 (6), pp.773-779. 〈10.3899/jrheum.160643〉 |
| بيانات النشر: | The Journal of Rheumatology, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | musculoskeletal diseases, medicine.medical_specialty, Combination therapy, TNF INHIBITORS, Immunology, Pharmacology, law.invention, Arthritis, Rheumatoid, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Randomized controlled trial, immune system diseases, Sulfasalazine, law, Internal medicine, medicine, Humans, Immunology and Allergy, heterocyclic compounds, 030212 general & internal medicine, skin and connective tissue diseases, Adverse effect, RHEUMATOID ARTHRITIS, TRIPLE THERAPY, 030203 arthritis & rheumatology, Biological Products, Tumor Necrosis Factor-alpha, business.industry, CONVENTIONAL TREATMENT, Hydroxychloroquine, medicine.disease, 3. Good health, DMARD, Methotrexate, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Rheumatoid arthritis, Drug Therapy, Combination, business, Rheumatism, medicine.drug |
| الوصف: | Objective.For patients with rheumatoid arthritis (RA) who have an inadequate response to methotrexate (MTX), the relative effectiveness of the combination of conventional disease-modifying antirheumatic drugs (DMARD) compared with the combination of tumor necrosis factor (TNF) inhibitors and MTX, as second-line therapy, is uncertain. The aim of this study was to compare the efficacy and tolerance of triple oral DMARD therapy versus anti-TNF agents associated with MTX in patients with RA after MTX failure.Methods.We performed a systematic search of the literature up to November 2015 in MEDLINE, Embase, the Cochrane library, and abstracts from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) meetings from 2006 to 2015. Articles were included if they were of randomized controlled trials of patients receiving triple oral combination therapy (TT; MTX + sulfasalazine + hydroxychloroquine) compared with anti-TNF agents plus MTX. Treatment effects were examined by disease activity [Disease Activity Score in 28 joints (DAS28)], ACR and EULAR response criteria, structural damage by the modified total Sharp score, and functional disability by the Health Assessment Questionnaire (HAQ).Results.Our search identified 263 articles; only 5 fulfilled the selection criteria. Analysis of ACR and EULAR response criteria, DAS28, and modified Sharp scores favored anti-TNF agents combined with MTX. Functional disability (HAQ) and rates of adverse events did not differ between treatments.Conclusion.In patients with RA in whom MTX has failed, the addition of a TNF antagonist to MTX may be a valid option, with better clinical outcomes and better radiographic results in the presence of poor prognostic factors. In the absence of poor prognostic factors and/or with contraindications to biologic agents, TT retains its place in the therapeutic strategy for RA in a currently restricted economic context. |
| تدمد: | 1499-2752 0315-162X |
| DOI: | 10.3899/jrheum.160643 |
| DOI: | 10.3899/jrheum.160643⟩ |
| DOI: | 10.3899/jrheum.160643〉 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9cb258824b0a6973eeb9cb67f3d61318 https://doi.org/10.3899/jrheum.160643 |
| رقم الانضمام: | edsair.doi.dedup.....9cb258824b0a6973eeb9cb67f3d61318 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14992752 0315162X |
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| DOI: | 10.3899/jrheum.160643 |