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Original article
Roohi sharma1,*, Rani Walia1, Shafiqa Aslam1, Parveen Gupta2
Affiliation:-
1Department of Pharmacology, Maharishi Markandeshwar Institute of Medical Science & Research, Mullana, Ambala, Haryana, India
2Department of Medicine, Markandeshwar Institute of Medical Science & Research, Mullana, Ambala, Haryana, India
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Pharmacology, Maharishi Markandeshwar Institute of Medical Science & Research, Mullana, Ambala, Haryana, India
2.Department of Medicine, Markandeshwar Institute of Medical Science & Research, Mullana, Ambala, Haryana, India
Address reprint requests to
Roohi Sharma.
Department of Pharmacology, Maharishi Markandeshwar Institute of Medical Science & Research, Mullana, Ambala, Haryana, India
Article citation:
Sharma R, Walia R, Aslam S,Gupta P. A comparative study of rheumatoid arthritis management with combination of methotrexate with hydroxychloroquine and sulfasalazine with hydroxychloroquine. J Pharm Biomed Sci. 2014;04(10):898-903. Available at www.jpbms.info
ABSTRACT
Rheumatoid arthritis, a chronic, systemic, inflammatory autoimmune disease, has as its primary target the synovial tissues. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour. When the disease is unchecked, it leads to substantial disability, which can make even simple tasks such as writing difficult, because joint damage can get worse, even when pain and swelling are relieved.
Objectives: To Compare the efficacy and safety of methotrexate and hydroxychloroquine and sulfasalazine and hydroxychloroquine in treatment of patients suffering from Rheumatoid Arthritis.
Research Design & Methods: Sixty(60) patients were included in this prospective, randomized, single blind comparative study and were divided into two groups. First group (Group A) consisted of thirty(30) patients that treated with MTX 7.5 mg once a week and HCQ 200 mg OD. The second group (Group B) consisted of thirty (30) patients were given SSZ 500 mg twice a day and HCQ 200 mg once daily. Assessment of efficacy of drug therapy was done via Clinical parameter which included Visual Analogue Scale and laboratory parameter comprised of ESR, LFTs & RFTs.
Results: There was a significant reduction in VAS in Group A as compared to Group B. There was a reduction in ESR levels in the both groups. No clinical noteworthy hematological and renal abnormalities were noted during treatment.
Conclusion: Methotrexate and hydroxychloroquine combination is more efficacious and equally safe and tolerable, like sulfasalazine and hydroxychloroquine thus suggestive of better quality of life in patients suffering from RA.
KEYWORDS: Rheumatoid arthritis, methotrexate; hydroxychloroquine; sulfasalazine; visual analogue scale; erythrocyte sedimentation rate.
REFERENCES
1.Kasper DL, Fauci AS, Longo DL et al. Rheumatoid Arthritis. Harrison’s Principles of Internal Medicine. McGraw Hill. 2008; (17):2083-2092.
2.Majithia V, Geraci SA, Swan JT et al. Rheumatoid arthritis diagnosis and management. Am J Med. 2007:120 (11):936-939.
3.Krishan J. Document on Rhuematoid arthritis. An approach to Early to Early Arthrits. Available at http://pn.lifehugger.com/doc/459 .[Accessed on 22/09/12]
4.Boland EW, Headley NE. Results of long-continued cortisone administration in rheumatoid arthritis. Calif Med. 1951; 74 (63): 416-423.
5.Smolen JS, Landewe R, Breedveld FC. Management of rheumatoid arthritis with synthetic and biological disease- modifying antirheumatic drugs. Ann Rheum Dis. 2010; 69:964-965.
6.Wasserman AM. Diagnosis and Management of Rheumatoid Arthritis. American Family Physician. 2011; 84 (11):1245-1252.
7.Deighton C, O’ Mahony R, Tosh J, Turner C, Rudolf M. Management of rheumatoid arthritis. British Medical Journal. 2009; 338:710-712.
8.Weinblatt ME. Rheumatoid arthritis: more aggressive approach improves outlook. Cleve Clin J Med. 2004; 71(5):409-413.
9.Borigini MJ, Paulus HE. Innovative treatment approaches for rheumatoid arthiritis. Combination therapy.ClinRheumatol. 1995; 9(4):689-710.
10.Westergren A "Diagnostic tests: the erythrocyte sedimentation rate range ". Triangle 3 (1): 20–5. PMID 13455726
11.Gaujoux-Viala C, Smolen JS, Landewé R, a randomized controlled trials of up to 1889 patients comparing monotherapy with LEF versus MTX. Pub med. 2011.
12.Trnavský K, Gatterová J, Lindusková M et al. Efficacy and toxicity of methotrexate (MTX) monotherapy versus MTX combination therapy with non-biological disease-modifying antirheumat ic drugs in rheumatoid arthritis: a systematic review and meta-analysis. Z Rheumatol. 1993; 52(5):292-6.
Source of support: None
Competing interest / Conflict of interest:
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Sharma R, Walia R, Aslam S, Gupta P. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.