Rheumatology Advance Access originally published online on July 15, 2008
Rheumatology 2008 47(9):1430-1431; doi:10.1093/rheumatology/ken240
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
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Tolerability of methotrexate and leflunomide combination therapy for inflammatory arthritis in routine clinical practice: results of a four-centre study
1St George's Healthcare NHS Trust, London, 2West Suffolk Hospital, Bury St Edmonds, 3Great Western Hospital, Swindon and 4Epsom and St Helier NHS Trust, Epsom, UK
Correspondence to: A. Kaul, Department of Rheumatology, Royal Free Hospital, Pond Street, London NW3 2QG, UK. E-mail: arvind.kaul@royalfree.nhs.uk
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SIR, Combination DMARD therapy is increasingly used for the treatment of inflammatory arthritis because monotherapy often does not produce remission [1]. The contrasting modes of action of MTX and LEF make them attractive candidates for use in combination [2] with the potential to provide additive or synergistic actions, perhaps without the need for expensive biologic agents [3].
Although combination DMARDs in early RA confer long-term structural advantages [4,5], meta-analysis of clinical trial