Rheumatoid arthritis drugs: all the same?
Rheumatoid arthritis is a debilitating disease that causes pain and damage to bone joints. It affects more than 2 million adults in the United States. It occurs between the ages of 30 and 55, and is more common in women than men. Typical signs may include joint swelling, pain, tiredness, and morning stiffness and they vary from person to person. Unfortunately, there is no cure for the disease and the treatment aims to reduce inflammation of joints to relieve pain and prevent or slow joint damage. The treatment option include agents known as disease modifying drugs, such as leflunomide, methotrexate and sulfasalazine and biological modifying drugs, such as adalimumab, etanercept and infliximab. The biological modifers are very expensive costing the patients billions of dollars annually.
In a review of comparative effectiveness of disease modifying drugs published in the Annals of Internal Medicine (www.annals.org, November 20, 2007), the authors reported that the evidence does not support one drug over another. The researchers from University of North Carolina analyzed 23 head to head trials and reported the findings. Adverse drug reactions were also similar among all agents.
The authors concluded that further research on comparative efficacy, effectiveness and harms of medications for treatment of rheumatoid arthritis is warranted.
