Abstract
(1) Background: We evaluated the clinical response of iguratimod (IGU) in patients with rheumatoid arthritis (RA) being treated with or without methotrexate (MTX) over 54 weeks. (2) Methods: 106 patients with RA undergoing IGU were retrospectively observed. RA patients were divided into those treated with MTX+IGU (n = 35) and those treated with IGU (n = 71). The primary endpoint was the clinical response of the Disease Activity Score assessing 28 joints with C-reactive protein (DAS28-CRP) differences in the changes from baseline to 54 weeks between MTX+IGU and IGU groups. Secondary endpoints, such as the clinical response, retention rate, and safety, were evaluated. (3) Results: The DAS28-CRP difference in the changes between the two groups were −0.2. DAS28-CRP were significantly reduced from the baseline in the MTX+IGU and IGU groups (−1.43 and −1.20 from baseline, respectively). The retention rates were 71.4% in the MTX+IGU groups and 59.2% in the IGU groups (p = 0.16). Adverse events were observed in a total of 6 (17.1%) MTX+IGU patients and 20 (28.2%) IGU patients (p = 0.21). (4) Conclusions: IGU therapy may be a useful treatment option for patients who cannot be treated with MTX.
Highlights
Rheumatoid arthritis (RA) is a well-known autoimmune disease which causes arthritis and is characterized by destruction of cartilage, bone, and tendon
(4) Conclusions: IGU therapy may be a useful treatment option for patients who cannot be treated with MTX
There were no significant differences between the two groups in the disease duration of RA, clinical disease activity (DAS28-C-reactive protein (CRP), TJC, SJC, and patient visual analogue scale (Pt-VAS)), or the positive percentage and titers of rheumatoid factor (RF) or anti-cyclic citrullinated peptide antibody (ACPA)
Summary
Rheumatoid arthritis (RA) is a well-known autoimmune disease which causes arthritis and is characterized by destruction of cartilage, bone, and tendon. Methotrexate (MTX) remains the anchor drug for the treatment of RA. MTX has contributed to improvement of various clinical symptoms, as well as disease control [1]. In 2016, the European League Against Rheumatism (EULAR) recommended that. MTX should be a part of the first-line treatment strategy for the management of RA [2]. For RA patients who show an inadequate response to MTX (MTX-IR), the add-on of another conventional synthetic disease-modifying antirheumatic drug (csDMARD) is an appropriate treatment option [3]. A combination therapy using csDMARD may be effective for the patients with MTX intolerance or an inadequate response to initial MTX therapy
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