The Therapeutic Effects Of A Combination Of Iguratimod And Methotrexate On Active Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory disease of synovial joints. Without treatment, deterioration of the joints leads to pain and stiffness that limits physical function and results in long-term disability. RA is a potentially destructive disease with profound impact on patients’ function and quality of life. Nowadays, RA therapy is still a big challenge for rheumatologists all over the world. Newer therapeutic agents have revolutionized outcomes but have not resulted in best outcomes for all patients because of the various reasons or the different responsiveness to the therapeutic agents. Hence, more and more new therapeutic methods, new treatment regimen, and new therapeutic agents will continue to be discovered for improvement RA disease. The aim of the present study is to explore the therapeutic effects of the new discovered small molecule disease-modifying antirheumatic drug (DMARD) iguratimod on the adult active RA patients who have experienced the therapy with other disease-modifying antirheumatic drugs (DMARDs). The main design of the present study is to investigate the effects of therapy with iguratimod plus methotrexate (MTX) in comparison with monotherapy with iguratimod or MTX in DMARDs-experienced adult patients with active RA. In the this study, the clinical course and background characteristics of patients with RA who fulfilled the American College of Rheumatology (ACR) classification criteria (1987) were investigated. All the patients met the following criteria:more than6tender joints, more than4swollen joints, erythrocyte sedimentation rate (ESR)≥28mm/h, or C-reactive protein (CRP) level>8.0mg/L. In the present study,131patients (24males,107females, mean age of46.63±10.61years) previously treated with MTX or other traditional DMARDs were investigated. All the patients involved in this study were randomly divided into3groups with the following treatment. The patients were treated with iguratimod (25mg, b.i.d. orally) plus MTX (orally at a week dose of10mg)(44patients), iguratimod (25mg, b.i.d. orally)(38patients) or MTX (orally at a week dose of10mg)(49patients), respectively, for24weeks. The results showed that iguratimod began exhibiting its therapeutic effect between4w and10w after the initiation of treatment and was effective even in patients who had a poor response to previous treatment with DMARDs. The combination of iguratimod with MTX was superior to monotherapy with iguratimod or MTX. And also, the combination of iguratimod with MTX did not significantly increase the risk of infection or liver damage. The data imply that iguratimod is a welcome addition to the small-molecule drug therapy for DMARD-experienced patients with active RA. Iguratimod (alone or in combination with MTX) is an emerging option for the treatment of DMARD-experienced adult patients with active RA who have had an inadequate response to or are intolerant of other DMARDs.