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| Effect of Methotrexate combined with Iguratimod in the treatment of patients with refractory rheumatoid arthritis |
| MENG Deqian PAN Wenyou▲ LI Ju LI Hui LI Fang LIU Shanshan LI Yongsheng CHENG Yuling |
| Department of Rheumatology, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu Province, Huai'an 223300, China |
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Abstract [Abstract] Objective To observe the effect of Methotrexate (MTX) combined with Iguratimod in the treatment of patients with refractory rheumatoid arthritis. Methods Sixty patients with refractory rheumatoid arthritis were all coming from Department of Rheumatology, Huai'an First People's Hospital, Nanjing Medical University from December 2013 to February 2014, they were randomly divided into experimental group and control group, with 30 cases in each group. The experimental group was given Iguratimod (50 mg/d) and MTX (15 mg one week), the control group was given the same dose of MTX, the course was 16 weeks. Before treatment and after treatment for 16 weeks, the disease activity score 28 (DAS28) was evaluated and recorded. And serum samples were retrieved, levels of tumor necrosis factor alpha (TNF-α) and vascular endothelial growth factor (VEGF) were quantified by enzyme-linked immunosorbent assays. Results There was no statistically significant difference of DAS28 score before treatment between the two groups [experimental group: (5.97±1.62) points; control group: (6.40±1.90) points; P ＞ 0.05]. After treatment for 16 weeks, DAS28 score of the two groups decreased significantly than before treatment [experimental group: (3.02±1.24) points; control group: (5.65±1.86) points], the differences were all statistically significant (P ＜ 0.01, P ＜ 0.05), and DAS28 score of the experimental group was reduced more obviously than that of control group, the difference was highly statistically significant (P ＜ 0.01). There was no statistically significant difference of TNF-α before treatment between the two groups [experimental group: (379.27±114.70) pg/mL; control group: (368.86±127.06) pg/mL, P ＞ 0.05]. After treatment for 16 weeks, the levels of TNF-α of the two groups were significantly reduced compared with those before treatment [experimental group: (230.42±67.23) pg/mL; control group: (309.65±95.59) pg/mL], the differences were all statistically significant (P ＜ 0.01, P ＜ 0.05), and the level of TNF-α of the experimental group decreased more obviously than that of control group, the difference was highly statistically significant (P ＜ 0.01). There was no statistically significant difference of VEGF before treatment between the two groups [experimental group: (1124.11±305.06) pg/mL; control group: (1142.02±174.02) pg/mL; P ＞ 0.05]. After treatment for 16 weeks, the levels of VEGF of the two groups were significantly reduced compared with those before treatment [experimental group: (818.89±178.78) pg/mL; control group: (1000.21±245.87) pg/mL], the differences were all statistically significant (P ＜ 0.01, P ＜ 0.05), and the level of VEGF of the experimental group decreased more obviously than that of control group, the difference was highly statistically significant (P ＜ 0.01). Conclusion MTX combined with Iguratimod has a good efficacy for treatment of patients with refractory rheumatoid arthritis, with high safety.
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