Combination therapy in rheumatoid arthritis

Current therapy with slow acting antirheumatic drugs (SAARDs) produce few remissions in rheumatoid arthritis. Significant numbers of patients become severely disabled and their life span is also reduced. Early treatment with SAARDs is now becoming accepted practice in an effort to reduce the rate of progression of erosive disease. Although combinations of SAARDs are now frequently used, few well controlled studies have been conducted and those that have in the main fail to demonstrate a clear benefit of the combination over single drug alone. Combinations of SAARDs with corticosteroids have demonstrated some benefit and a reduction in side effects and further well designed studies of combination therapy are required to ascertain if the theoretical potential benefit of these combinations can be demonstrated in patients.