Abstract
Objectives: To examine the effects of conventional disease-modifying anti-rheumatic drugs(DMARDs) on rheumatoid factor(RF) or anti-cyclic citrullinated peptide(CCP) antibodies in patients with early rheumatoid arthritis(RA).
Methods: Patients with early RA were randomized to treatment with salazosulfapyridine(SASP) or bucillamine(BUC) monotherapy for 1 year with the option of a 1-year extension. Methotrexate(MTX) was added if SASP or BUC monotherapy had inadequate efficacy. Efficacy(determined using European League Against Rheumatism criteria), anti-CCP antibodies, and RF were assessed at 0,1,3,6,9, and 12 months after starting treatment.
Results: Of 10 patients treated with SASP and 9 treated with BUC, MTX was added to 5 and 2, respectively. The response and remission rates in all 19 patients were 63.2％ and 57.9％, respectively. Baseline anti-CCP antibodies and RF, and their rates of change at 1,3, and 12 months did not affect the remission or good response rates. Mean RF and anti-CCP antibodies decreased significantly from 3 and 6 months, respectively, relative to their baseline.
Conclusion: It was suggested that the therapy with DMARDs centering on SASP and BUC in patients with early RA reduces anti-CCP antibodies and RF, and decreases in the two indices stabilize the disease activity of RA. ―Although clinical, structural, and functional remissions are desired in recent RA treatment, we should also aim for immunological remission using the two indices; we considered that this is where the significance of using DMARDs classified as immunomodulatory drugs such as SASP and BUC lies.
