Skip to main content
Erschienen in: Zeitschrift für Rheumatologie 8/2016

29.10.2015 | Originalien

Iguratimod in combination with methotrexate in active rheumatoid arthritis

Therapeutic effects

verfasst von: Z. Xia, J. Lyu, N. Hou, L. Song, X. Li, H. Liu

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Rheumatoid arthritis (RA) is a potentially destructive disease that may have a profound impact on patients’ function and quality of life. RA therapy is still a challenge for rheumatologists; however, new antirheumatic drugs may be a treatment option for disease-modifying antirheumatic drug (DMARD)-experienced patients with active RA.

Objectives

The present study is a prospective trial that aims to investigate the effects of therapy with iguratimod plus methotrexate (MTX) in comparison with iguratimod or MTX monotherapy in DMARD-experienced adult patients with active RA.

Methods

A total of 131 patients (24 men, 107 women, mean age 46.63 ± 10.61 years) with a history of being treated with traditional DMARDs were investigated. In all, 44 patients were treated with iguratimod (25 mg, twice daily, orally) plus MTX (a weekly dose of 10 mg, orally), 38 patients received iguratimod (25 mg, twice daily, orally), or 49 patients received MTX (weekly dose of 10 mg, orally) for 24 weeks.

Results

A therapeutic effect with iguratimod was observed between 4 and 10 weeks after treatment initiation and was effective even in patients who had a poor response to previous treatment with DMARDs. The combination of iguratimod with MTX was superior to iguratimod or MTX monotherapy.

Conclusion

The data imply that iguratimod is a welcome addition to the small-molecule drug therapy for DMARD-experienced patients with active RA. Iguratimod (alone or in combination with MTX) is an emerging option for the treatment of DMARD-experienced adult patients with active RA who have had an inadequate response to or are intolerant of other DMARDs.
Literatur
1.
Zurück zum Zitat Hawtree S, Muthana M, Wilson AG (2013) The role of histone deacetylases in rheumatoid arthritis fibroblast-like synoviocytes. Biochem Soc Trans 41:783–788CrossRefPubMed Hawtree S, Muthana M, Wilson AG (2013) The role of histone deacetylases in rheumatoid arthritis fibroblast-like synoviocytes. Biochem Soc Trans 41:783–788CrossRefPubMed
2.
Zurück zum Zitat Kaufmann J, Feist E, Roske AE et al (2013) Monotherapy with tocilizumab or TNF-alpha inhibitors in patients with rheumatoid arthritis: efficacy, treatment satisfaction, and persistence in routine clinical practice. Clin Rheumatol 32:1347–1355CrossRefPubMed Kaufmann J, Feist E, Roske AE et al (2013) Monotherapy with tocilizumab or TNF-alpha inhibitors in patients with rheumatoid arthritis: efficacy, treatment satisfaction, and persistence in routine clinical practice. Clin Rheumatol 32:1347–1355CrossRefPubMed
3.
Zurück zum Zitat Bykerk VP, Schoels MM (2013) Treatment strategies for early rheumatoid arthritis. Curr Opin Rheumatol 25:375–383CrossRefPubMed Bykerk VP, Schoels MM (2013) Treatment strategies for early rheumatoid arthritis. Curr Opin Rheumatol 25:375–383CrossRefPubMed
4.
Zurück zum Zitat Mucke HA (2012) Iguratimod: a new disease-modifying antirheumatic drug. Drugs Today (Barc) 48:577–586 Mucke HA (2012) Iguratimod: a new disease-modifying antirheumatic drug. Drugs Today (Barc) 48:577–586
5.
Zurück zum Zitat Liu DY, Lon HK, Wang YL et al (2013) Pharmacokinetics, pharmacodynamics and toxicities of methotrexate in healthy and collagen-induced arthritic rats. Biopharm Drug Dispos 34:203–214CrossRefPubMed Liu DY, Lon HK, Wang YL et al (2013) Pharmacokinetics, pharmacodynamics and toxicities of methotrexate in healthy and collagen-induced arthritic rats. Biopharm Drug Dispos 34:203–214CrossRefPubMed
6.
Zurück zum Zitat Coury FF, Weinblatt ME (2010) Clinical trials to establish methotrexate as a therapy for rheumatoid arthritis. Clin Exp Rheumatol 28(5 Suppl 61):S9–S12PubMed Coury FF, Weinblatt ME (2010) Clinical trials to establish methotrexate as a therapy for rheumatoid arthritis. Clin Exp Rheumatol 28(5 Suppl 61):S9–S12PubMed
7.
Zurück zum Zitat Goodman S (2010) Measuring methotrexate polyglutamates. Clin Exp Rheumatol 28(5 Suppl 61):S24–S26PubMed Goodman S (2010) Measuring methotrexate polyglutamates. Clin Exp Rheumatol 28(5 Suppl 61):S24–S26PubMed
9.
Zurück zum Zitat McWilliams DF, Kiely PD, Young A et al (2013) Baseline factors predicting change from the initial DMARD treatment during the first 2 years of rheumatoid arthritis: experience in the ERAN inception cohort. BMC Musculoskelet Disord 14:153CrossRefPubMedPubMedCentral McWilliams DF, Kiely PD, Young A et al (2013) Baseline factors predicting change from the initial DMARD treatment during the first 2 years of rheumatoid arthritis: experience in the ERAN inception cohort. BMC Musculoskelet Disord 14:153CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Smolen JS, Landewé R, Breedveld FC et al (2010) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 69:964–975CrossRefPubMedPubMedCentral Smolen JS, Landewé R, Breedveld FC et al (2010) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 69:964–975CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Fiehn C (2010) Methotrexate transport mechanisms: the basis for targeted drug delivery and ß-folate-receptor-specific treatment. Clin Exp Rheumatol 28(5 Suppl 61):S40–S45PubMed Fiehn C (2010) Methotrexate transport mechanisms: the basis for targeted drug delivery and ß-folate-receptor-specific treatment. Clin Exp Rheumatol 28(5 Suppl 61):S40–S45PubMed
12.
Zurück zum Zitat Weinblatt ME (2013) Methotrexate in rheumatoid arthritis: a quarter century of development. Trans Am Clin Climatol Assoc 124:16–25PubMedPubMedCentral Weinblatt ME (2013) Methotrexate in rheumatoid arthritis: a quarter century of development. Trans Am Clin Climatol Assoc 124:16–25PubMedPubMedCentral
13.
Zurück zum Zitat Rath T, Rubbert A (2010) Drug combinations with methotrexate to treat rheumatoid arthritis. Clin Exp Rheumatol 28(5 Suppl 61):S52–S57PubMed Rath T, Rubbert A (2010) Drug combinations with methotrexate to treat rheumatoid arthritis. Clin Exp Rheumatol 28(5 Suppl 61):S52–S57PubMed
14.
Zurück zum Zitat Ishiguro N, Yamamoto K, Katayama K et al (2013) Concomitant iguratimod therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate: a randomized, double-blind, placebo-controlled trial. Mod Rheumatol 23:430–439CrossRefPubMed Ishiguro N, Yamamoto K, Katayama K et al (2013) Concomitant iguratimod therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate: a randomized, double-blind, placebo-controlled trial. Mod Rheumatol 23:430–439CrossRefPubMed
15.
Zurück zum Zitat Fransen J, Riel PL van (2005) The disease activity score and the EULAR response criteria. Clin Exp Rheumatol 23(5 Suppl 39):S93–S99PubMed Fransen J, Riel PL van (2005) The disease activity score and the EULAR response criteria. Clin Exp Rheumatol 23(5 Suppl 39):S93–S99PubMed
16.
Zurück zum Zitat Felson DT, Smolen JS, Wells G et al (2011) American college of rheumatology/European league against rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Arthritis Rheum 63:573–586CrossRefPubMedPubMedCentral Felson DT, Smolen JS, Wells G et al (2011) American college of rheumatology/European league against rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Arthritis Rheum 63:573–586CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Smolen JS, Landewé R, Breedveld FC et al (2014) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 73:492–509CrossRefPubMed Smolen JS, Landewé R, Breedveld FC et al (2014) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 73:492–509CrossRefPubMed
18.
Zurück zum Zitat Hara M, Abe T, Sugawara S et al (2007) Efficacy and safety of iguratimod compared with placebo and salazosulfapyridine in active rheumatoid arthritis: a controlled, multicenter, double-blind, parallel-group study. Mod Rheumatol 17:1–9CrossRefPubMed Hara M, Abe T, Sugawara S et al (2007) Efficacy and safety of iguratimod compared with placebo and salazosulfapyridine in active rheumatoid arthritis: a controlled, multicenter, double-blind, parallel-group study. Mod Rheumatol 17:1–9CrossRefPubMed
19.
Zurück zum Zitat Hara M, Ishiguro N, Katayama K et al (2014) Safety and efficacy of combination therapy of iguratimod with methotrexate for patients with active rheumatoid arthritis with an inadequate response to methotrexate: an open-label extension of a randomized, double-blind, placebo-controlled trial. Mod Rheumatol 24:410–418CrossRefPubMed Hara M, Ishiguro N, Katayama K et al (2014) Safety and efficacy of combination therapy of iguratimod with methotrexate for patients with active rheumatoid arthritis with an inadequate response to methotrexate: an open-label extension of a randomized, double-blind, placebo-controlled trial. Mod Rheumatol 24:410–418CrossRefPubMed
Metadaten
Titel
Iguratimod in combination with methotrexate in active rheumatoid arthritis
Therapeutic effects
verfasst von
Z. Xia
J. Lyu
N. Hou
L. Song
X. Li
H. Liu
Publikationsdatum
29.10.2015
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 8/2016
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-015-1641-y

Weitere Artikel der Ausgabe 8/2016

Zeitschrift für Rheumatologie 8/2016 Zur Ausgabe

Update Rheumatologie

Update Rheumatologie

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.