DMARD combinations as good as biologicals in RA

Combinations of disease-modifying agents (DMARDs) are as effective as a biological agent plus methotrexate in slowing radiographic progression in patients with rheumatoid arthritis, according to US analysts (Arthr Rheum 2010; published online. doi: 10.1002/art. 27592).

    Their meta-analysis of 70 randomised trials showed that a single DMARD plus steroids reduced annual radiographic progression rate by 50-65 per cent compared with placebo. Com­pared with single DMARD therapy, combinations of two or three DMARDs or a DMARD plus a biological agent both reduced the radio­graphic progression rate by 50-80 per cent.
    The authors say their data were too heterogeneous to rank individual agents.