Dr. Vappu Rantalaiho of Tampere University Hospital, Finland, and colleagues analyzed radiologic progression in 195 patients with rheumatoid arthritis -- 97 of whom had randomly initially received therapy combining methotrexate, sulfasalazine and hydroxychloroquine with prednisolone and 98 of whom received a single strategy -- initially sulfasalazine with or without prednisolone. After two years, the treatment was unrestricted for both groups.
The findings of the 11-year trial, published in the journal Arthritis Research & Therapy, found patients treated with a combination of drugs initially were found to have less radiographic damage in small joints, even long-term, than those treated initially with monotherapy.
"Probably the most important precondition to our excellent results in most patients was the active treatment policy aiming at remission at all time points," Rantalaiho said in a statement.
"In the present study, the patients who were in strict remission at one year had significantly less radiologic progression throughout the follow-up than the patients who were not."