Stopping second-line drug therapy in rheumatoid arthritis

Canadian Medical Association Journal 1996; 155: 200-201

Source: ten Wolde S, Breedveld FC, Hermans J et al: Randomised placebo-controlled study of stopping second-line drugs in rheumatoid arthritis. Lancet 1996; 347: 347-352

Researchers in the Netherlands conducted a double-blind trial to assess whether 285 patients with rheumatoid arthritis who had good long-term responses to second-line drug therapy would benefit from continuation of such treatment. Patients were randomly assigned to continue the second-line therapy or to receive a placebo. At 52 weeks patients who continued the second-line therapy had a significantly lower incidence of mild and severe disease flare than patients who received the placebo. Although disease activity worsened in both groups during the study period, patients who continued therapy experienced few serious side effects and obtained better results on clinical and laboratory indices of disease activity than the control group. Risk factors for flare in patients who discontinued the second-line drug therapy were a high maintenance dose of the drug before the study and continuing positive test results for rheumatoid factor.

| CMAJ July 15, 1996 (vol 155, no 2) | International digest |