Combination Therapies in Spondyloarthropathies

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OBJECTIVES To compare the efficacy and tolerability of single-agent sulfasalazine(SSZ) with combination therapies composed of SSZ and methotrexate (MTX) and SSZ,MTX and hydroxychloroquine (HCQ) in active spondyloarthropathy (SpA) patientswith peripheral arthritis.METHODS One hundred and fifty SpA patients with peripheral arthritis (male/female: 92/58) who were treated in our clinic between 1994 and 1998 were enrolled inthis trial. Patients treated with SSZ alone (1-3 gr/day) were included in Group I,patients treated with combination of SSZ (1-3 gr/day) and MTX (7.5-15 mg/week) inGroup II, and patients treated with combination of SSZ (1-3 gr/day), MTX (7.5-15mg/week) and HCQ (200 mg/day) in Group III. Forty-eight patients in Group I, 45patients in Group II and III were eligible for statistical analysis at the end of study.RESULTS The combination of MTX, SSZ, and HCQ, and the combination of MTXand SSZ were more effective regarding the clinical and laboratory parameters thanSSZ alone (p<0.05). Moreover, the combination of MTX, SSZ, and HCQ was moreeffective than the combination of MTX and SSZ (p<0.05).CONCLUSION Combination therapies seem to be more effective and no more toxicthan monotherapy in SpA patients with peripheral arthritis.
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