Therapy in Early Aggressive RA Is Important but Might Not Require Biologics

In patients with early rheumatoid arthritis, standard triple therapy (methotrexate, hydroxychloroquine, and sulfasalazine) is almost equivalent to methotrexate plus etanercept.

Debate is ongoing about appropriate timing and comparative efficacy of various treatment regimens for early rheumatoid arthritis (RA). The question is critical, because the monthly cost of biologics can be US$2000 higher than traditional antirheumatic drugs. In this 2-year, manufacturer-supported study, 755 patients with early RA were randomized to immediate treatment with methotrexate and the biologic etanercept (Enbrel); immediate oral triple therapy (methotrexate, hydroxychloroquine, and sulfasalazine); methotrexate monotherapy with step-up at 24 weeks to methotrexate plus etanercept; or methotrexate monotherapy with step-up at 24 weeks to triple therapy. The endpoint was a standard disease activity score (involving the erythrocyte sedim…

Reviewing Author

Jonathan S. Coblyn, MD

Therapy in Early Aggressive RA Is Important but Might Not Require Biologics

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Reviewing Author