Rheumatology Advance Access originally published online on June 16, 2003
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rheumatology 2003; 42: 1545-1549
© 2003 British Society for Rheumatology
Radiographic progression in early rheumatoid arthritis: a 12-month randomized controlled study comparing the combination of cyclosporin and methotrexate with methotrexate alone
Rheumatology Department, University of Milan and 1Radiology Department, G. Pini Orthopaedic Institute, Milan, Italy
Correspondence to:
A. Marchesoni, Rheumatology Department, G. Pini Orthopaedic Institute, Via G. Pini 9, 20122 Milano, Italy. E-mail: marchesoni{at}gpini.it
Objective. To determine whether patients with early rheumatoid arthritis (RA) treated with cyclosporin A (CsA) and methotrexate (MTX) in combination for 12 months show a lower rate of radiographic deterioration than those treated with MTX alone.
Methods. In this controlled and randomized single-blind trial, 61 consecutive patients with untreated RA of less than 2 yr duration were treated with either CsA + MTX combination therapy (n = 30) or MTX alone (n = 31). The primary end-point was radiographic progression after 12 months, measured using the damage score (DS) of the Sharp and van der Heijde method.
Results. Although there was a significant difference between the mean baseline and 12-month DS in both treatment groups (MTX/CsA, 1.93 ± 0.90; MTX, 7.47 ± 2.03), it was significantly less in the combination arm (P = 0.018). Of the 30 evaluable CsA + MTX patients, 16 (53%) were ACR20 responders, 15 (50%) ACR50 and 14 (47%) ACR70; the corresponding figures in the MTX arm were 19 (61%), 13 (44%) and 6 (19%). Toxicity was acceptable in both groups.
Conclusions. In patients with early RA, CsA + MTX combination therapy led to a significantly lower rate of 12-month radiographic progression, was effective on inflammatory articular symptoms, and was well tolerated.
KEY WORDS: Rheumatoid arthritis, Combination therapy, Cyclosporin, Methotrexate.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E H S Choy, C M Smith, V Farewell, D Walker, A Hassell, L Chau, D L Scott, and for the CARDERA (Combination Anti-Rheumatic Drugs Factorial randomised controlled trial of glucocorticoids and combination disease modifying drugs in early rheumatoid arthritis Ann Rheum Dis, May 1, 2008; 67(5): 656 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. P M Goekoop-Ruiterman, J. K de Vries-Bouwstra, C. F Allaart, P. J S M Kerstens, B. A M Grillet, M. H de Jager, K H. Han, I. Speyer, P. A H M van der Lubbe, P. E H Seys, et al. Patient preferences for treatment: report from a randomised comparison of treatment strategies in early rheumatoid arthritis (BeSt trial) Ann Rheum Dis, September 1, 2007; 66(9): 1227 - 1232. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Combination therapy for early rheumatoid arthritis DTB, November 1, 2006; 44(11): 81 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Pucino Jr., P. T. Harbus, and R. Goldbach-Mansky Use of biologics in rheumatoid arthritis: Where are we going? Am. J. Health Syst. Pharm., September 15, 2006; 63(18 Suppl 4): S19 - S41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. S. Choy, C. Smith, C. J. Dore, and D. L. Scott A meta-analysis of the efficacy and toxicity of combining disease-modifying anti-rheumatic drugs in rheumatoid arthritis based on patient withdrawal Rheumatology, November 1, 2005; 44(11): 1414 - 1421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G F FERRACCIOLI, P TOMIETTO, and M DE SANTIS Rationale for T Cell Inhibition by Cyclosporin A in Major Autoimmune Diseases Ann. N.Y. Acad. Sci., June 1, 2005; 1051(1): 658 - 665. [Abstract] [Full Text] [PDF]
|
|