A RETROSPECTIVE STUDY OF TREATING RA PATIENTS WITH VARIOUS COMBINATIONS OF SLOW-ACTING ANTIRHEUMATIC DRUGS IN A COUNTY HOSPITAL

During the period 1/1990-9/1995 a total of 311 RA patients were challe nged 458 times with 52 different COMBOs. As the first COMBO methotrexa te (MTX), sulphasalazine (SSZ), im gold (GOLD), and hydroxychoroquine (HCQ) were combined with each other in 272/311 cases. The respective s ix and 12 months survivals of these COMBOs were 68,6% (95%CI 63;0% to 74,3%) and 53,6% (95%CI 47,4% to 59,9%). Inefficacy (27, 9%), rather t han adverse events (23, 5%) or other causes (16, 9%) was the leading r eason for the discontinuations. Only in five cases (1, 8%) these COMBO s were discontinued due to a remission. Not a single adverse event rel ated to a COMBO treatment was judged as serious. The mean survival tim e for COMBOs including MTX (24, 0 months; 95%CI 20, 6 to 27, 4) was st atistically significantly longer than the respective time for COMBOs w ithout MTX (14, 5 months; 95%CI 11, 2 to 17, 7). We conclude that, whe n meticulously monitored, the treatment with COMBOs is safe. However, their efficacy on patients with advanced RA is modest. The survival ti me for COMBOs including MTX is longer than COMBOs without MTX.