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Page: << Prev | 1 | 2 | 3 | Next >> Adalimumab and etanercept had better short-term results. However, biologics and methotrexate boost the risk of serious infection, including a reoccurrence of tuberculosis, the researchers found.
Donahue's team also found that prednisone, along with hydroxychloroquine, methotrexate or sulfasalazine worked better in reducing joint swelling and tenderness than using a synthetic DMARD alone.
There was no difference in effectiveness between the synthetic DMARDs methotrexate, leflunomide and sulfasalazine. And combining methotrexate and sulfasalazine was no more effective than using either one of the drugs alone.
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There was also not enough evidence to say whether combining two biologics was more effective than using one biologic, Donahue said. For every 1,000 people taking a biologic for three to 12 months, 17 have a serious infection and combining two biologics can increase that risk, the researchers noted.
In addition, rates of painful injection site reactions are more common for anakinra (67 percent) than for etanercept (22 percent) or adalimumab (18 percent), Donahue's group found.
Donahue recommended that patients talk to their doctors about developing a treatment plan that is tailored to their individual condition. "Rheumatoid arthritis is very patient-specific -- there are many therapies, and there doesn't appear to be one therapy that is clearly superior," she said. "It's a conversation between you and your rheumatologist about what might be right for you."
One expert said the study will be useful for physicians.
"This is a great summary about what we know about how DMARDs work," said Dr. Steven Vlad, a fellow in rheumatology at Boston University Medical Center. "That basic finding -- that one synthetic of biologic doesn't work any better than others -- is a good thing to remind ourselves of," he said.
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