Iguratimod versus salazosulfapyridine in rheumatoid arthritis patients with an inadequate response to methotrexate: Adjusted with propensity score matching.

Abstract

OBJECTIVES:

Methotrexate (MTX) is recommended as a first-line conventional synthetic disease-modifying antirheumatic drug (csDMARD) for treating rheumatoid arthritis (RA). This retrospective study sought to identify an add-on csDMARD treatment strategy for RA patients with MTX-inadequate response (IR).

METHODS:

We collected the cases of RA patients treated with salazosulfapyridine (SASP) or iguratimod (IGU) as the additional csDMARD for MTX-IR during a 24-month follow-up. We performed propensity score matching to evaluate the retention rate, clinical efficacy, and safety profile (n = 54, each group).

RESULTS:

The retention rates at 24 months were 38.5% (MTX+SASP group) and 67.8% (MTX+IGU group). At 3 and 6 months, the MTX+IGU group's 28 joint-disease activity score (DAS28) was significantly decreased versus the MTX+SASP group, and at 3 months the MTX+IGU group's good-responder percentage (22.9%) was significantly higher versus the MTX+SASP group's good-responder percentage (10.7%). Conversely, compared to the MTX+SASP group, the MTX+IGU group showed a greater reduction in the estimated glomerular filtration rate from baseline during follow-up.

CONCLUSIONS:

IGU is a useful add-on csDMARD for RA patients with MTX-IR; its high retention rate and good clinical response make it a useful combination therapy for controlling RA disease activity. However, the renal function should be monitored during follow-up.

• Authors: Yuji Nozaki, Motohiro Oribe, Daisuke Tomita, Tetsu Itami, Shinya Hayashi, Toshihisa Maeda, Koji Fukuda, Ryosuke Kuroda, Keiko Funahashi, Tsukasa Matsubara, Koji Kinoshita, Itaru Matsumura
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 33 Issue 3 Pg. 472-480 (Apr 13 2023) ISSN: 1439-7609 [Electronic] England
• PMID: 35695707 (Publication Type: Journal Article)
• Copyright: © Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Methotrexate
• Sulfasalazine
• iguratimod
• Antirheumatic Agents

Topics

• Humans
• Methotrexate (therapeutic use)
• Sulfasalazine (therapeutic use)
• Retrospective Studies
• Propensity Score
• Drug Therapy, Combination
• Arthritis, Rheumatoid (drug therapy)
• Antirheumatic Agents (adverse effects)
• Treatment Outcome