Literature DB >> 9858426

How Canadian and US rheumatologists treat moderate or aggressive rheumatoid arthritis: a survey.

A Maetzel1, C Bombardier, V Strand, P Tugwell, G Wells.   

Abstract

OBJECTIVE: To determine which second line agents Canadian and US rheumatologists use to treat patients with active rheumatoid arthritis (RA).
METHODS: A one page survey was sent by fax or mail to all 263 members of the Canadian Rheumatology Association and 320 members of the American College of Rheumatology (10% random sample weighted by region) known to practice adult rheumatology. The survey asked for first and second treatment preferences in patients with (1) aggressive RA; (2) moderate RA; and (3) aggressive RA failing a trial of methotrexate (MTX) 25 mg.
RESULTS: Altogether 231 (87.8%) Canadian and 230 (71.7%) US rheumatologists responded, and 214 responses in each survey were analyzable. In aggressive RA. MTX was the drug of first choice of most Canadian (68.7%) and US (78.5%) rheumatologists. Intramuscular gold was a drug of first choice for 14.5 and 1.9% of Canadians and Americans, respectively. 93.9% of Canadian and 90.2% of US respondents preferred single agents for the treatment of moderate RA. Among US rheumatologists. no clear leader emerged as a single agent alternative for the management of aggressive RA unresponsive to MTX. Most said they would use combination (38.3%) or triple (23.8%) therapy involving MTX plus sulfasalazine and/or hydroxychloroquine. 52.3% of Canadians preferred single agent therapy, with 34.6% choosing gold as an alternative to MTX.
CONCLUSION: Canadian and US rheumatologists preferred MTX for the treatment of aggressive RA. Canadian rheumatologists saw a small but significant role for intramuscular gold. No single agent emerged as a clear alternative to MTX among US rheumatologists.

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Year:  1998        PMID: 9858426

Source DB:  PubMed          Journal:  J Rheumatol        ISSN: 0315-162X            Impact factor:   4.666


  6 in total

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3.  Limited efficacy of conventional DMARDs after initial methotrexate failure in patients with recent onset rheumatoid arthritis treated according to the disease activity score.

Authors:  Sjoerd M van der Kooij; Jeska K de Vries-Bouwstra; Yvonne P M Goekoop-Ruiterman; Derkjen van Zeben; Pit J S M Kerstens; Andreas H Gerards; Johannes H L M van Groenendael; Johanna M W Hazes; Ferdinand C Breedveld; Cornelia F Allaart; Ben A C Dijkmans
Journal:  Ann Rheum Dis       Date:  2007-02-09       Impact factor: 19.103

Review 4.  Efficacy, tolerability and cost effectiveness of disease-modifying antirheumatic drugs and biologic agents in rheumatoid arthritis.

Authors:  Michael T Nurmohamed; Ben A C Dijkmans
Journal:  Drugs       Date:  2005       Impact factor: 9.546

5.  A multicentre, double blind, randomised, placebo controlled trial of anakinra (Kineret), a recombinant interleukin 1 receptor antagonist, in patients with rheumatoid arthritis treated with background methotrexate.

Authors:  S B Cohen; L W Moreland; J J Cush; M W Greenwald; S Block; W J Shergy; P S Hanrahan; M M Kraishi; A Patel; G Sun; M B Bear
Journal:  Ann Rheum Dis       Date:  2004-04-13       Impact factor: 19.103

6.  Methotrexate versus combination methotrexate and etanercept for rheumatoid arthritis.

Authors:  Aarat M Patel; Larry W Moreland
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  6 in total

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