Treatment of rheumatoid arthritis with methotrexate in Congolese patients

Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) but data concerning the effectiveness of treatment with this compound are lacking in the Congolese population. In the present study, the evolution of RA in Congolese patients on MTX treatment is reported from before...

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Bibliographic Details
Published in:Clinical rheumatology 2013-09, Vol.32 (9), p.1323-1327
Main Authors: Malemba, J. J., Mbuyi Muamba, J. M., Mukaya, J., Bossuyt, X., Verschueren, P., Westhovens, R.
Format: Article
Language:English
Subjects:
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Democratic Republic of the Congo
Disease Progression
Female
Humans
Male
Medicine
Medicine & Public Health
Methotrexate - therapeutic use
Middle Aged
Original Article
Poverty
Prednisone - administration & dosage
Remission Induction
Rheumatology
Steroids - therapeutic use
Surveys and Questionnaires
Time Factors
Treatment Outcome
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Summary:Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) but data concerning the effectiveness of treatment with this compound are lacking in the Congolese population. In the present study, the evolution of RA in Congolese patients on MTX treatment is reported from before disease-modifying antirheumatic drug (DMARD) initiation till 20 months later. All consecutive DMARD-naïve RA patients (ACR 1987 criteria) attending the rheumatology unit of the University Hospital of Kinshasa from January 2008 to September 2010 were included. All were treated with MTX (started at 7.5 mg/week) and bridging steroids (started at 30mg/day). Treatment adaptations of MTX and concomitant drugs are reported as well as evolution of disease activity (DAS28-ESR), functionality (Health Assessment Questionnaire), radiological damage, and safety over 20 months. Of 98 patients recruited, more than one third were lost at follow-up. A follow-up visit at 20 months was available for 51 patients. These 48 women and 3 men had a mean age of 51.2 ± 13 years and a mean delay from symptom onset till their first visit of 3.2 years. At 20 months, the average MTX dose was 9.7 mg weekly. A second DMARD was added in three patients. The average dose of prednisone at 20 months was 7.5 mg daily. A significant improvement of DAS28 and functional disability was observed and 35.3 % of patients entered remission (DAS28
ISSN:0770-3198
1434-9949
DOI:10.1007/s10067-013-2269-4