A new combination of drugs allows for a cheap, effective and relatively safe treatment of rheumatoid arthritis, using smaller doses of each drug with less risk of side effects..

Researcher Diederik De Cock from the Catholic University of Louvain in Belgium published his findings in the Annals of Rheumatic Diseases.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that presents with joint pain and stiffness, fatigue, bone damage, and eventually loss of motor function..

In Western countries, rheumatoid arthritis affects about 1% of the population.. In Belgium, between 80,000 and 100,000 people are currently living with the disease..

Since rheumatoid arthritis cannot be completely eliminated, the treatment is to suppress the inflammation of the joints.. Therapy for RA has improved significantly over the past decades, and today clinical trials of new methods for the treatment of rheumatoid arthritis at an early stage are being conducted in several countries around the world to prevent joint damage and improve the quality of life of patients..

In a 2-year study called CareRA (Care in early RA), staff at the University Hospital of Louvain explored different ways to treat rheumatoid arthritis early. Their goal was to find the optimal combination of antirheumatic drugs (methotrexate, sulfasalazine, leflunomide) and corticosteroids (a group of steroid hormones with anti-inflammatory action).

The researchers divided 290 patients with rheumatoid arthritis into three groups.. Each group received different combinations of drugs:.

•COBRA Classic: methotrexate, leflunomide, high first dose of corticosteroids.

•COBRA Avant-Garde: methotrexate, leflunomide, moderate dose corticosteroids.

•COBRA Slim: methotrexate and a moderate dose of corticosteroids.

All three strategies showed equally high efficacy: remission was achieved in 7 out of 10 patients after 16 weeks of treatment.. But in terms of side effects, these three treatment strategies were very different..

The new COBRA Slim strategy, which used the lowest doses of drugs, was safer - side effects were observed twice as often as with the other two treatment regimens. This treatment strategy was easier to implement in clinical practice.. Scientists say that the wider use of such a treatment regimen on a global scale would lead to a significant increase in the effectiveness of therapy and reduce medical costs..

Diederik de Kock, from the Center for Musculoskeletal Biology at KU Leuven, summed up: “Our results show that this strategy achieves high results.. Methotrexate is more affordable than corticosteroids. The implementation of this strategy throughout Flanders would lead to significant cost savings. At the moment, the treatment of RA in different regions of Belgium is not equally standardized, and this is the reason for the inefficiency. As a result, more patients are in need of second-line therapy - biologics, which can cost up to 15,000 euros per year..

For comparison, the COBRA Slim strategy will cost 1,000 euros. In other words, for one amount, 15 patients can be cured instead of one.”.

The study was supported by the Agency for Innovation in Science and Technology (IWT) and a division of Pfizer. The research team was assisted by Professor Patrick Verschueren of the Catholic University of Louvain. Scientists carried out their work on the basis of several centers of rheumatology in Flanders.

medbe. en.