Clinical efficacy of methotrexate combined with leflunomide in the treatment of rheumatoid arthritis / 中国基层医药

ABSTRACT

Objective To investigate the clinical efficacy of methotrexate combined with leflunomide in the treatment of rheumatoid arthritis. Methods From January 2017 to February 2018,90 patients with rheumatoid arthritis in Shengzhou Hospital of Traditional Chinese Medicine were divided into control group and observation group according to the random number table method,with 45 cases in each group. The control group was treated with metho-trexate,the observation group was treated with methotrexate and leflunomide. The clinical efficacy of the two groups was evaluated. The anti - cyclic citrullinated peptide antibody (ACCP),rheumatoid factor (RF),and C - reactive protein (CRP) levels were measured before and after 4 months of treatment. The adverse reactions were recorded. Results The total effective rate in the observation group was 95. 56％ after 4 months of treatment,which was signifi-cantly higher than 80. 00％ in the control group (χ2 = 8. 196,P = 0. 016). The ACCP,RF and CRP levels in the two groups were significantly decreased after treatment for 4 months. The ACCP,RF and CRP levels in the observation group were (12423. 68 ± 174. 82) U/ L,(6. 24 ± 2. 14) U/ L,and (6. 69 ± 3. 32) mg/ L,respectively,which were significantly lower than those in the control group [(15421. 27 ± 287. 33) U/ L,(16. 58 ± 3. 26) U/ L,(10. 14 ± 5. 22)mg/ L,t = 59. 787,17. 786,3. 741,P = 0. 000,0. 000,0. 000]. The incidence rate of adverse reaction in the observation group was 6. 67％ ,which in the control group was 4. 44％ ,the difference between the two groups was not statistically significant ( χ2 = 0. 211, P = 0. 645). Conclusion Methotrexate combined with leflunomide in the treatment of rheumatoid arthritis can significantly improve the clinical efficacy,reduce the serum ACCP,RF,CRP levels in patients with a certain degree of control of the disease,while not increasing adverse reactions,has certain degree of safety.