Comparison of the Effects of Iguratimod Combined with Methotrexate and Diacerein Respectively on Relat-ed Indexes of Refractory Rheumatoid Arthritis / 中国药房

ABSTRACT

OBJECTIVE:To compare the effects of iguratimod combined with methotrexate and diacerein respectively on relat-ed indexes of refractory rheumatoid arthritis (RRA). METHODS:98 RRA patients were randomly divided into control group (48 cases)and observation group(50 cases). Control group received Iguratimod tablet 25 mg,twice a day+Methotrexate tablet with ini-tial dose of 10 mg,once a week,increased to 12.5 mg after 2 weeks,increased to 15 mg in the second courses,once a week. Ob-servation group received Iguratimod tablet(the same dosage and usage with control group)+Diacerein granule 50 mg,twice a day. 4-week was a course,they were treated for 6 courses. Morning stiffness time,the numbers of 28 joints tenderness and swelling,28 joint disease activity score (DAS28),erythrocyte sedimentation rate (ESR),rheumatoid factor (RF),IL-1,vascular endothelial growth factor (VEGF),tumor necrosis factor (TNF)-α,C-reaction protein (CRP),malondialdehyde (MDA),superoxide dis-mutase(SOD),total antioxidant capacity(TAOC),early peak flow(peak E),left ventricular late flow peak flow(peak A),E/A and left ventricular ejection fraction(LVEF)before and after treatment,and the incidence of adverse reactions in 2 groups were ob-served. RESULTS:Before treatment,morning stiffness time,the numbers of 28 joints tenderness and swelling,DAS28 score, ESR,RF,IL-1,TNF-α,CRP,VEGF,MDA,TAOC and peak A in 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group;SOD,peak E,E/A and LVEF in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group,with statistical significances (P0.05). CONCLUSIONS:Iguratimod combined with diacerein is superior to iguratimod combined with methotrexate in improving cardiac function,oxidation-antioxidant imbalance play and reducing inflammatory reactions in the treatment of RRA,with similar safety.