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Second-line drugs used in recent-onset rheumatoid arthritis in Brittany (France)
Authors:Saraux Alain  Berthelot Jean-Marie  Chalès Gérard  Le Henaff Catherine  Thorel Jean  Hoang Sylvie  Martin Antoine  Allain Jérĵme  Nouy-Trolle Isabelle  Devauchelle Valérie  Youinou Pierre  Le Goff Paul
Affiliation:Rheumatology department of Brest, h?pital de la Cavale-Blanche, France. Alain.Saraux@univ-brest.fr
Abstract:OBJECTIVE: The management of recent-onset rheumatoid arthritis (RA) is not well standardized. We conducted a survey of drugs prescribed to RA patients in Brittany at presentation and during the first 1 to 3 years of follow-up. METHODS: A cohort of 270 patients with recent-onset inflammatory joint disease was recruited between 1995 and 1997. The evaluation at presentation included a medical history, a thorough physical examination, and a standard battery of investigations. Follow-up at 6-month intervals was offered. At the last visit, between June and December 1999, a panel of five rheumatologists established that 98 patients had RA. RESULTS: At presentation, hydroxychloroquine and injectable gold were the most widely used second-line drugs, and only two patients were offered a combination of second-line drugs. At the last visit, the most commonly used drugs were methotrexate, injectable gold, and hydroxychloroquine (23, 23, and 21 patients, respectively); only three patients were on more than one second-line drug and 38 (38/98, 39%) patients were on glucocorticoid therapy. CONCLUSION: Rheumatologists in Brittany prefer monotherapy with hydroxychloroquine or injectable gold as the initial treatment. Later, they rely mainly on methotrexate, injectable gold, and hydroxychloroquine, often in combination with glucocorticoid therapy.
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