Comparison of treatment results of rheumatoid arthritis with DMARDS and anti TNF drugs based on the disease activity and remission criteria

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder of unknown etiology that primarily involves joints. Although RA treatment with DMARDs is effective, there are still a great amount of patients whose disease activity can not be fully controlled. Recent advances in treatment of RA provides alternative treatment regimens for unresponsive patients to classical treatment. Anti TNF agents are most frequently used new drugsData were collected by means of a retrospective study of the files of the 75 active RA patients who were followed-up in physical medicine and rehabilitation clinics. The demographic features, the duration of diseases, clinical and laboratory data were recorded from these files. Thirty-seven patients who were taken anti TNF (infliximab, etanersept, adalimumab) plus methotrexate constituted the first group and 38 patients who were taken DMARDs (leflunomide+methotrexate, sulfasalazine+methotrexate and methotrexate alone) constituted the second group. The DAS 28, VAS and HAQ parameters of all participant were calculated. The therapeutic efficacy was evaluated by means of ACR20, 50 ve 70 criteriaThere was no significant difference between the age and sex of groups involved into this study. Mean age in patients with treated anti TNF and DMARDs was determined respectively 50.27±7.9 and 46.79±8.6. There was an statistically significant difference in only HAQ score before treatment. A significant decrease in values of all disease activity parameters was noted but this reduction was significantly greater in the group treated with a biologic agent than in DMARDs group.After 6 months there were statistically significant differences among treatment groups in the HAQ, DAS28, VAS parametres. In our study the proportions of patients achieving ACR20, 50 and 70 responses were also greater in the anti TNF treatment group with 81, 54, 22%, respectively, compared with 44, 15, 0% in DMARDs group (p<0.001In conclusion, anti TNF drugs were found significantly effective in reduction of disease activity and functional disability and ACR responses with respect to DMARDs.Key words: Rheumatoid arthritis, anti TNF, DMARDs, ACR20-70.