Rheumatoid Arthritis: But which drugs work?

There are plenty of drugs around for treating rheumatoid arthritis – but doctors don’t have a clue which ones work.  Even though researchers have been analysing the different drugs for this disabling disease for 30 years, there is still no clear-cut guidance for doctors about the best ones to choose.

Effectively, doctors know only that the two main drug groups – the synthetic agents, such as methotrexate and sulfasalazine, and the anti-tumour necrosis factor agents, such as etanercept and infliximab – are about as good, or bad, as each other.  

Researchers carried out a meta-analysis of 101 studies and concluded that, on their own, each of the two drug groups has a similar therapeutic effect, and has similar side effects.  Combining the two drugs seemed to help a little, especially when just one of the drugs on its own was having little effect, but there was insufficient data to categorically assert that this was the better approach.

(Source: Annals of Internal Medicine, 2007; published online, 20 November).

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