Clinical Observation Of Iguratimod In The Treatment Of Rheumatoid Arthritis

Objective:Rheumatoid arthritis(RA)is a multi-systemic inflammatory autoimmune disease involving mainly peripheral joints.,The prevalence rate of RA is the highest among autoimmune connective tissue diseases,with a high disability rate.The common treatment drugs include nonsteroidal anti-inflammatory drugs(NSAIDs),disease modifying antirheumatic drugs(DMARDs),and biological DMARDs.The first line drugs are methotrexate(MTX)and leflunomide(LEF).MTX is a classical DMARDs,which is widely used in the treatment of RA because of its effectiveness,safety and low price.In addition to the ineffectiveness to the two drugs in a proportion of patients,there are still some patients who have to stop using because of drug resistance and side effects.Therefore,a new drug regimen is needed to solve the above problems.Iguratimod is a small molecular anti-rheumatic drug,which was first marketed in China in 2011.It can inhibit the production of inflammatory cytokines,immunoglobulin,and COX-2.It has been widely used in the treatment of RA in recent years.Due to the short clinical application time,current domestic studies generally focus on the efficacy of single drug treatment for RA or other diseases,and there are few studies on the comparison of efficacy between iguratimod and commonly used DMARDs,efficacy of combined treatment,side effects,prognosis and other aspects.Therefore,this study will compare iguratimod with MTX and LEF,respectively,and discuss the efficacy of their combined treatment.Methods:To study the efficacy,safety,complications and combination with DMARDS of Iguratimod on Rheumatoid arthritis,200 patients with Rheumatoid arthritis who met the RA diagnostic criteria in our hospital were divided into 4 groups.Group 1A is MTX,group 1B is MTX+ Iguratimod,group 2A is LEF,group 2B is LEF + Iguratimod.The patients were followed up for 24 weeks.Clinical and laboratory indicators,including number of joint tenderness(28 arthroscopy),number of joint swelling(28 arthroscopy),CRP and ESR,were collected before treatment and at 12 and 24 weeks after treatment,and the DAS 28 was calculated before treatment and 12 and 24 weeks after treatment.DAS28 disease activity evaluation: remission(< 2.6),low activity(>2.6 ~ ≤3.2),moderate activity(>3.2 ~ ≤5.1),high activity(>5.1).Make statistical analysis to study the clinical effectiveness of Iguratimod.Result:The ESR(mm/h),CRP(mg/L),tenderness joint,swelling joint,RF(IU/ml)and DAS28 in MTX group,MTX + Iguratimod group and LEF group,LEF + Iguratimod group decreased with the prolongation of treatment time.At week 0,there was no difference in each index level among the 4 groups.At 12 weeks of treatment,the ESR,CRP and DAS28 levels in the MTX+ Iguratimod group were significantly lower than those in the MTX group,and the ESR,RF and DAS28 levels in the LEF+ Iguratimod group were significantly lower than those in the LEF group.At the 24 th week of treatment,the ESR,CRP and DAS28 levels in the MTX+Iguratimod group were significantly lower than those in the MTX group,and the ESR,CRP,tenderness joint,RF and DAS28 levels in the LEF+ Iguratimod group were significantly lower than those in the LEF group.Conclusion:The efficacy of Iguratimod combined with MTX was better than that of MTX group alone,and that of Iguratimod combined with LEF was better than that of LEF group alone.The clinical symptoms and activity scores of rheumatoid arthritis were significantly improved,and the efficacy gradually increased with the prolongation of treatment time.