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Methotrexate Is Anchor Drug For Most Rheumatoid Arthritis Patients

Close to 90% of patients with recent onset rheumatoid arthritis are using methotrexate as the anchor drug a year into their therapy with disease modifying antirheumatic drugs.

More than 60% use methotrexate (MTX) alone or with traditional disease modifying antirheumatic drugs (DMARD), while 30% use leflunomide, etanercept or infliximab, usually along with methotrexate.

These are among chief findings of a long-term observational study of use of DMARD and biological agents in a group of 232 rheumatoid arthritis (RA) patients receiving routine clinical care in five different United States rheumatology practices.

Drs Tuulikki Sokka and Theodore Pincus from Vanderbilt University, Nashville, Tennessee, sought to evaluate RA treatments and long-term outcomes in these patients.

At baseline, the researchers reviewed all DMARD taken since disease onset, clinical measures on a multidimensional health assessment questionnaire, joint counts and laboratory data.

Among the 232 patients, MTX was the first DMARD used in 192 patients (82.8%).

Over a median interval of 12.1 months, 125 patients (66.1%) of the 189 whose initial DMARD was MTX as a single DMARD continued it as a single DMARD, 43 (22.8%) had another DMARD or biological agent added in combination with MTX and 21 (11.1%) discontinued MTX.

Since the onset of their RA, 89.2% of the patients had taken MTX, 15.9% hydroxychloroquine, 3.9% sulfasalazine, 22% leflunomide, 9.5% etanercept, 4.3% infliximab and 87.0% prednisone.
J Rheumatol 2002;29:2521-4. "Contemporary Disease Modifying Antirheumatic Drugs (DMARD) in Patients with Recent Onset Rheumatoid Arthritis in a US Private Practice: Methotrexate as the Anchor Drug in 90% and New DMARD in 30% of Patients"

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