COMPARISON OF AZATHIOPRINE, METHOTREXATE, AND THE COMBINATION OF BOTH IN THE TREATMENT OF RHEUMATOID-ARTHRITIS - A CONTROLLED CLINICAL-TRIAL

被引:118
作者
WILLKENS, RF
UROWITZ, MB
STABLEIN, DM
MCKENDRY, RJR
BERGER, RG
BOX, JH
FIECHTNER, JJ
FUDMAN, EJ
HUDSON, NP
MARKS, CR
BROOKS, R
ROONEY, TW
RUBIN, BR
SCHMID, FR
SEGAL, AM
THOMAS, JW
GOLDSTEIN, AG
YUNUS, MB
WORTMANN, RL
SHERRER, YRS
机构
[1] UNIV WASHINGTON, SCH MED, DEPT INTERNAL MED, SEATTLE, WA 98195 USA
[2] UNIV TORONTO, DEPT CHEM, TORONTO M5S 1A1, ONTARIO, CANADA
[3] EMMES CORP, POTOMAC, MD USA
[4] OTTAWA GEN HOSP, OTTAWA K1H 8L6, ONTARIO, CANADA
[5] UNIV N CAROLINA, SCH MED, CHAPEL HILL, NC 27514 USA
[6] ARTHRITIS CLIN, CHARLOTTE, NC USA
[7] UNIV N DAKOTA CLIN, GRAND FORKS, NC USA
[8] BAYLOR COLL MED, DEPT MED, HOUSTON, TX 77030 USA
[9] OHIO STATE UNIV, DEPT MED, COLUMBUS, OH 43210 USA
[10] UNIV WASHINGTON, SEATTLE, WA 98195 USA
[11] VANDERBILT UNIV, DIV RHEUMATOL & IMMUNOL, NASHVILLE, TN 37240 USA
[12] MERCY ARTHRITIS CTR, DES MOINES, IA USA
[13] NORTHWESTERN UNIV, SCH MED, CHICAGO, IL 60611 USA
[14] CLEVELAND CLIN EDUC FDN, CLEVELAND, OH 44106 USA
[15] TEXAS COLL OSTEOPATH MED, FT WORTH, TX 76107 USA
[16] ARTHRITIS ASSOCIATES NO VIRGINIA, FALLS CHURCH, VA USA
[17] UNIV ILLINOIS, COLL MED, PEORIA, IL 61656 USA
[18] MED COLL WISCONSIN, MILWAUKEE, WI 53226 USA
[19] CLEVELAND CLIN FLORIDA, FT LAUDERDALE, FL USA
来源
ARTHRITIS AND RHEUMATISM | 1992年 / 35卷 / 08期
关键词
D O I
10.1002/art.1780350802
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To compare the relative safety and efficacy of azathioprine (AZA), methotrexate (MTX), and the combination of both in the treatment of active rheumatoid arthritis (RA). Methods. Two hundred twelve patients with active RA were entered into a 24-week prospective, controlled, double-blind, multicenter trial and were randomly assigned to 1 of 3 treatment groups. Results. One hundred fifty-eight patients finished 24 weeks of the study. There were no remissions seen but response rates were greater than 30% for all outcome measures. Combination therapy was not statistically superior to MTX therapy alone, but both combination therapy and MTX alone were superior to AZA alone when patients were analyzed by intent-to-treat and with withdrawals treated as therapy failures. If only patients who continued taking the therapy were analyzed, the mean improvement was greater for AZA therapy than for MTX, while the combination remained the most active. Adverse effects on the gastrointestinal tract and elevations of liver enzyme levels were the most frequent causes for discontinuations. Conclusion. Both combination therapy and MTX alone were superior to therapy with AZA alone for active RA but were not statistically different in their effect on outcome assessment.
引用
收藏
页码:849 / 856
页数:8
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