© 1990 British Society for Rheumatology
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THE CYCLING OF COMBINATION ANTIRHEUMATIC DRUG THERAPY IN RHEUMATOID ARTHRITIS

*Sydney University Department of Rheumatology Royal North Shore Hospital, St Leonards, NSW, 2065 Australia
Health Information Systems Royal North Shore Hospital, St Leonards, NSW, 2065 Australia
Correspondence to:
Correspondence to Dr A. Schwarzer
In this open pilot study a combination of hydroxychioroquine, prednisolone and alternating months of treatment with sulphasalazine or oral weekly pulse methotrexate has been investigated in 16 patients with rheumatoid arthritis (RA) refractory to a total of 67 disease suppressive medications. Results at 3 months indicated significant improvements in visual analogue score for pain, joint count, Ritchie index, scale of disability related to activities of daily living, ESR, rheumatoid factor and C-reactive protein. This degree of improvement, however, was not maintained 6 and 12 months after commencement of treatment. Pain score, Ritchie index and ESR were the only parameters demonstrating significant improvement at 12 months. Therapy was terminated in eight patients, half due to lack of efficacy and half because of side effects.
KEY WORDS: Arthritis, Treatment, Methotrexate, Sulphasalazine, Antimalarials, Corticosteroids
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