UNMC Researchers Determine Combination Drug Therapy
Still Most Effective Treatment for Rheumatoid Arthritis
A research study conducted by the University of Nebraska Medical Center
and involving 44 rheumatologists in six states has determined that a combination
of three drugs is still a very effective treatment for rheumatoid arthritis.
The results of the study were announced earlier this month at the annual
meeting of the American College of Rheumatology held in Boston.
Dr. James O’Dell, professor and chief of the rheumatology section of
the department of internal medicine at UNMC, served as principal investigator
for the study, which was actually a follow-up study of a 1996 study reported
in The New England Journal of Medicine.
In the 1996 study, it was determined that a combination of three drugs
methotrexate, sulfasalazine and hydroxychloroquine was more effective
in treating rheumatoid arthritis than methotrexate alone or the combination
of sulfasalazine and hydroxychloroquine.
In the current study, the combination three-drug therapy was compared
to methotrexate and hydroxychloroquine as well as methotrexate and sulfasalazine.
The two-year, double-blind, randomized study involved 171 patients.
Neither the patients nor the physicians knew what drug therapy patients
were receiving.
Patients were monitored during the study to determine how many experienced
at least a 20 percent improvement at one year and maintained at least that
degree of improvement for two years without drug toxicity.
Results found that 77 percent of patients taking the three-drug combination
showed at least 20 percent improvement, while only 52 percent of methotrexate/hydroxychloroquine
patients realized a 20 percent improvement and 47 percent of methotrexate/sulfasalazine
patients experienced a 20 percent improvement.
“The triple drug therapy has become the most widely used treatment for
rheumatoid arthritis in the United States and Europe, so the results of
this study should be reaffirming to the millions of rheumatoid arthritis
sufferers who are on this combination,” Dr. O’Dell said. “The combination
therapy is ideal for people who have not done well with previous therapies.
If patients are doing well on their present single drug therapy, I would
recommend that they continue on this regimen.”
Rheumatoid arthritis is an autoimmune disorder that affects more than
2 million Americans. It is a chronic disease that causes pain, stiffness,
swelling and loss of function in the joints and inflammation in other body
organs. It’s estimated that rheumatoid arthritis results in more than 9
million physician visits and more than 250,000 hospitalizations per year.
There is no cure for rheumatoid arthritis, so the goal of treatment is
to achieve remissions or near remissions.
Patients participating in the study came through the Rheumatoid Arthritis
Investigational Network (RAIN), a group of 44 rheumatologists and nurse-study
coordinators located throughout Nebraska, Iowa, South Dakota, Minnesota,
Illinois and California. Founded in 1989, RAIN has the goal of bringing
rheumatologists at UNMC together with private practice rheumatologists
who are interested in clinical study. The RAIN home office is located at
UNMC.
To find out more about this study, people should call Dr. O’Dell’s office
at (402) 559-7288.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education, outreach and patient care,
UNMC has established itself as one of the country’s leading centers for
arthritis research, cancer research and treatment and solid organ transplantation.
Nearly $31 million in research grants and contracts were awarded to UNMC
scientists during the past fiscal year. In addition, UNMC’s educational
programs are responsible for training more health professionals practicing
in Nebraska than any other institution.