System evaluation of methotrexate therapy and triple therapy for rheumatoid arthritis

doi:10.3969/j.issn.2095-4344.2013.52.018

Abstract

Abstract:

BACKGROUND: At present, it is controversial to choose methotrexate therapy alone or triple therapy in the treatment of rheumatoid arthritis.

OBJECTIVE: To systemically evaluate the efficacy and safety of methotrexate therapy and methopterin + hydroxychloroquine + sulfasalazine triple therapy in the treatment of rheumatoid arthritis.

METHODS: Computer retrieval was performed on the Cochrane library, PubMed, EMBASE NRR (http://www.updatesoftware.com/National), CCT (http://www.controlled-trails.com) and the Chinese biomedical literature database. Manual retrieval was performed on Chinese major orthopedic journals. Randomized controlled trials of methotrexate therapy alone and methopterin + hydroxychloroquine + sulfasalazine triple therapy treatment for rheumatoid arthritis were collected. Methodological quality of the included studies was evaluated. The statistical software Revman 5.0 provided by the Cochrane collaboration was used.

RESULTS AND CONCLUSION: A total of four literatures in a randomized controlled trial, a total of 297 cases were included; the methodological quality was all class B. Meta-analysis results showed that blood sedimentation improvements were larger in methotrexate therapy alone than in the triple therapy [mean difference = 7.01, 95% confidence interval (CI) (2.82, 11.19), P = 0.001). Improvements of joints were better in triple therapy than that in single therapy [OR=0.62, 95%CI (0.41, 0.95), P = 0.03). There was no significant difference in adverse events. Meta analysis could not be done in ACR, because literature did not provide detailed data. Compared with the triple therapy treatment, methotrexate therapy alone obviously reduced the sedimentation of rheumatoid arthritis in adults, but in terms of joint function improvement, triple therapy was superior to methotrexate therapy alone. Moreover, on the adverse event, there was no significant difference between the two groups. Because this system evaluation included a less number of cases, it still needs strict large-sample randomized controlled studies to increase the strength of the evidence.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: arthritis, rheumatoid, methotrexate, hydroxychloroquine, sulfasalazine, blood sedimentation

CLC Number:

R318

Zhang Lei, Nuerai•Shawutali, Aynaz•Badelhan, Yang Kang-hua, Wulanbai•Tangkejie, Huang Yong, Jiasharete•Jielile. System evaluation of methotrexate therapy and triple therapy for rheumatoid arthritis[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(52): 9049-9054.

Figures/Tables 2

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