Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
I had editorialized recently about whether we are paying enough attention to the value of oral, inexpensive triple DMARDs for our patients with RA1. Since then this new report from O’Dell et al in the NEJM adds further support to the value of triple DMARDs as comparable to the biologic etanercept plus methotrexate2. Unfortunately an accompanying editorial asks “we have to consider, however, whether these findings have arrived too late to influence modern practice, in which arguably a TNF inhibitor is the preferred next step when methotrexate alone is inadequate”3. Is it really too late for us to consider the cost of health care as a concern of ours? At the recent EULAR congress Strand noted that the CORRONA registry data is showing that after two years 58% of patients given a biologic had discontinued it. Isn’t it time to not just automatically go to a biologic without giving triple DMARDs a try?
1 Schumacher HR. Are we being open enough to all approaches to therapy of rheumatoid arthritis? J Clin Rheumatol. 2013;19:167-71.
2 O'Dell JR, Mikuls TR, Taylor TH, Ahluwalia V, Brophy M, Warren SR, Lew RA, Cannella AC, Kunkel G, Phibbs CS, Anis AH, Leatherman S, Keystone E; CSP 551 RACAT Investigators. Therapies for active rheumatoid arthritis after methotrexate failure. N Engl J Med. 2013;369:307-18.
3 Bathon JM, McMahon DJ. Making rational treatment decisions in rheumatoid arthritis when methotrexate fails. N Engl J Med. 2013;369:384-5.
Journal of Clinical Rheumatology
Subscribe to this Blog's RSS Feed
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at JCR: Journal of Clinical Rheumatology.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.