Abstract
Usefulness of combined therapy involving addition of salazosulfapyridine (SASP-combined therapy) was evaluated in patients with rheumatoid arthritis refractory to Methotrexate (MTX). The study involved 47 patients with RA (6 males and 41 females) with a mean age of61. 8years. Mean duration of sickness was 12 years and 11 months. Mean DAS28CRP at the start of SASP-combined therapy was 3. 10. The outcome of treatment in these cases was compared with the outcome of MTX-combined therapy for 14 SASP refractory cases (mean DAS28CRP:2.78) and 14 cases refractory to other drugs treated with MTX＋SASP simultaneously(mean DAS28CRP: 3.45). The response rate (percentage of cases showing moderate or good responses) was slightly lower in the SASP-combined therapy group (57.4%) than in the MTX-combined therapy group (78.6%) and the simultaneous MTX＋SASP therapy group (85.7%). A noteworthy finding was that remission was maintained in 30.6％ of all cases in analysis of long-term outcome of SASP-combined therapy. In analysis of changes in modified total Sharp score (mTSS) in 11 cases where the time course of the score could be followed for one year or longer, mean TSS at the time of evaluation after the start of SASP-combined therapy (4.43) was significantly lower than the mean score at the start of therapy (8.79), that is, a significant ΔTSS on the minus side was recorded in the SASP-combined therapy group during this period, suggesting usefulness of this therapy in suppressing bone/joint destruction. Taken together, these results allow us to say that combined therapy involving addition of SASP is a useful alternative when dealing with patients with rheumatoid arthritis refractory to MTX.
