Rheumatoid Arthritis Clinical Trial
Official title:
Comparison of Combination Disease Modifying Antirheumatic Drugs (DMARDs) With Single Drug (Methotrexate) Therapy in Early Rheumatoid Arthritis
This study will be conducted to find out how well a patient of rheumatoid arthritis (RA) will respond to disease-modifying antirheumatic drugs (DMARDs). RA is a chronic inflammatory arthritis, which leads to joint damage & disability if not treated properly. A DMARD is used to treat RA that slows down or prevents joint damage, as opposed to just relieve pain or inflammation by painkillers. The study will be conducted at the Department of Clinical Immunology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research). Patients will receive either a single DMARD (Methotrexate) or combination DMARDs therapy (Methotrexate + Leflunomide + Hydroxychloroquine). During treatment course, routine blood investigations will be carried out to monitor treatment response and side effects.
Patients aged ≥18 years, fulfilling the 2010 ACR EULAR criteria for RA (symptom duration less
than one year) & having moderate to severe disease activity (DAS28≥3.2) will be invited to
participate. After providing written informed consent, eligible patients will be stratified
into two groups. Block randomization will be done to generate random allocation sequence.
Treatment Group I will be treated with Methotrexate (MTX) monotherapy and Treatment Group II
will be treated with Methotrexate + Leflunomide (LEF) + Hydroxychloroquine (HCQ) combination
therapy. Concurrent treatment with non-steroidal anti-inflammatory drugs in adequate dose and
oral low dose Glucocorticoids (GC) (max: 15 mg/d) will be allowed during the study.
DMARD dosages used are: MTX 25 mg/week orally (dosage after 6 weeks), LEF 20 mg/day (dosage
after 2 weeks) and HCQ 400 mg/day. GCs will be given in an oral tapering scheme. All patients
will be prescribed folic acid (10 mg/week) during MTX prescription.
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