Pyramids to myriads: The combination conundrum in rheumatoid arthritis

D. O’Gradaigh¹, D.G.I. Scott²

¹Donncha O'Gradaigh, Specialist Registrar in Rheumatology, Department of Rheumatology, Box 204, Addenbrook Hospital, Cambridge CB2 2QQ, UK; ²Professor David G.I. Scott, Consultant Rheumatologist, Honorary Professor, University of East Anglia, Department of Rheumatology, Norfolk and Norwich Hospital, Norwich NR1 3SR, UK.

ABSTRACT
Rheumatoid arthritis continues to be a cause of significant morbidity and disability. Increased understanding of the immunopathogenesis of the disease, of its progression over time, and of patient characteristics which correlate with outcome, have allowed more appropriate therapy. However, currently available disease-modifying therapy fails to adequately control disease in many patients, and many combinations of these drugs have therefore been described. In this review, we critically evaluate the existing literature, identifying combinations for which reasonable evidence of efficacy exists, and highlighting important issues in interpreting such evidence as well as issues of drug monitoring in such patients.

Key words
Rheumatoid, treatment, combination, DMARD.

Please address correspondence and reprint requests to Dr. Donncha O’Gradaigh.

Clin Exp Rheumatol 1999; 17 (Suppl. 18): S13 - S19.
© Copyright Clinical and Experimental Rheumatology 1999.