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Combination therapies in spondyloarthropathies
Meral Calgüneri1, Veli Cobankara, M Akif Oztürk
1Department of Rheumatology, Hacettepe University School of Medicine, Ankara, Turkey.
The Kobe Journal of Medical Sciences
|January 22, 2005
Summary
Combination therapies including sulfasalazine (SSZ) with methotrexate (MTX) and hydroxychloroquine (HCQ) are more effective for spondyloarthropathy (SpA) with peripheral arthritis than SSZ alone. These combinations show improved clinical and laboratory outcomes without increased toxicity.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Spondyloarthropathy (SpA) with peripheral arthritis requires effective treatment strategies.
- Sulfasalazine (SSZ) is a common monotherapy, but its efficacy in combination regimens is under investigation.
Purpose of the Study:
- To compare the efficacy and tolerability of single-agent SSZ versus combination therapies (SSZ + methotrexate [MTX]; SSZ + MTX + hydroxychloroquine [HCQ]) in SpA patients with peripheral arthritis.
Main Methods:
- A trial involving 150 SpA patients with peripheral arthritis treated between 1994-1998.
- Patients were divided into three groups: SSZ alone (Group I), SSZ + MTX (Group II), and SSZ + MTX + HCQ (Group III).
- Clinical and laboratory parameters were analyzed for 48 patients in Group I and 45 in Groups II and III.
Main Results:
- Combination therapies (MTX + SSZ + HCQ and MTX + SSZ) demonstrated superior efficacy over SSZ monotherapy for clinical and laboratory parameters (p<0.05).
- The triple combination (MTX + SSZ + HCQ) was more effective than the dual combination (MTX + SSZ) (p<0.05).
Conclusions:
- Combination therapies for SpA with peripheral arthritis appear more effective than monotherapy.
- The studied combination regimens were not associated with increased toxicity compared to SSZ monotherapy.