Abstract

Objective To assess the efficacy and safety of tacrolimus (TAC) combined with methotr-exate (MTX) for the treatment of refractory rheumatoid arthritis (RA), and to compare it with cyclophosphamide (CTX) added to MTX for the treatment of refractory RA. Methods Thirty-six cases of refractory RA patients were divided into the observation group and the control group. TAC+MTX were used in the observation group, and CTX+MTX were used in the control group. We used repeated measures to analyze the variance and Fisher exact probability method to analyze the efficacy at 8 weeks and 24 weeks. Results The effective rate of the observation group in 8 weeks, 24 weeks were 77.8%(14 cases) and 100%(18 cases) respectively, while those of the control group were 11.1% (2 cases) and 44.4%(8 cases), it showed that both TAC+MTX and CTX+MTX in the treatment of refractory RA were effective, but the efficacy of TAC+ MTX was better than CTX+ MTX, the difference of C reactive protein (CRP) and disease activity score (DAS)28 was statistically significant (P<0.05), and it could significantly improve the clinical symptoms and laboratory indexes. Conclusion TAC+ MTX is effective and safe in treating refractory RA, and is worth of spreading. Key words: Arthritis, rheumatoid; Methotrexate; Treatment outcome; Tacrolimus

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