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Separate Treatments Strategies Needed for Disease Modifying Antirheumatic Drugs in Rheumatoid and Psoriatic Arthritis

Patients with psoriatic arthritis (PsA) appear to have more side effects when treated with disease modifying antirheumatic agents (DMARDs) than do patients with rheumatoid arthritis (RA).

These findings suggest that these two groups of patients require different treatment strategies, particularly when use of DMARDs is being considered, according to I. Ujfalussy and colleagues at the Polyclinic of the Hospitaller Brothers of St. John of God, Budapest, Hungary.

Results of their study also suggest that earlier results seen on the safety of DMARDs in the treatment of RA "may not be directly applicable to PsA," they write.

The researchers analysed the records of 102 RA and 104 PsA patients using Cox regression, life-table analysis and log rank test. They compared the effectiveness and toxicity as well as the duration of therapy with DMARDs in each patient group.

Patients with RA were treated with gold sodium thiomalate (GST) for a median duration of 35 months, methotrexate (MTX) for 72 months and sulphasalazine (SSZ) for a median of 12 months. Those in the PsA group were treated with GST for a median of 12 months, MTX for 12 months and SSZ for 17 months.

There was a statistically significant differences between GST and MTX (P=0.0043 and P=0.0447).

Patients with PsA had more frequent rate of drug toxicity (P=0.0023) but no difference in efficacy was seen between groups.
Z Rheumatol 2003 Apr;62:2:155-60. "Original contribution : Termination of disease-modifying antirheumatic drugs in rheumatoid arthritis and in psoriatic arthritis. A comparative study of 270 cases"

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