Rheumatoid Arthritis Management More Important than New Drugs
Posted Jan 17 2011 5:48pm
There have been a significant number of new treatments introduced for rheumatoid arthritis (RA) in recent years. New research indicates that in spite of this, management of the disease with older drugs, such as methotrexate, is more important.
A team of researchers, led by Isidoro Gonzalez-Alvaro from the Hospital Universitario de la Princesa, Spain, studied the treatment records of 789 patients from 34 different medical centers between the years of 2000 and 2004. They found improvements in disease activity scores, functional ability and radiological progression whether or not new treatments were utilized.
According to Gonzalez-Alvaro, “Our work shows that the treatment of rheumatoid arthritis at tertiary hospitals in Spain has improved from the year 2000. It is likely that better management of available drugs, mainly methotrexate, has been learned during the last decade – along with the clinical development of most biologic agents.”
Therapies for managing RA have changed substantially over the last 10 years reflected in the development of biologic therapies and rigorous clinical trials. These have contributed to the overall improvement in RA management.
However, the researchers found that the effectiveness of new drugs outside of the clinical trials may be different than in practice. In fact, they did not observe the halt of radiological progression described in clinical trials. Several factors contribute to this difference:
Patients in clinical trials on average are younger
Patients in clinical trials show greater disease activity
Patients in clinical trial have secondary conditions to RA
Drugs in clinical trials are prescribed according to strict protocols
They also write in their report, published in Arthritis Research and Therapy, “The most relevant finding of our work is that disease activity in RA has improved, independently of the availability of new therapies, in patients with severe and mild disease.”