PARTICULARITIES OF TREATMENT WITH CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs) IN A GROUP OF PATIENTS WITH RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is a systemic inflammatory disease with destructive joint damage, causing severe functional impairment. Due to the complex mechanism of action of the various representatives from the group of conventional synthetic (CS) DMARDs, the different side-effect profile and the variability in patient response to treatment, the therapeutic management of RA with CS DMARDs is a real challenge in everyday clinical practice. The present study aims to identify the specific features of treatment with conventional agents in a group of RA patients monitored in an outpatient clinic. The present study was an observational, retrospective, descriptive cohort type of study, in witch, we included patients diagnosed with RA under treatment only with CS DMARDs (30 patients). Demographic, clinical and treatment data were registered and also adverse reactions to treatment. Effectiveness of treatment was evaluated using disease activity score for RA (DAS28). All data presented are expressed as mean +/- SD for continuous variables and as number and/or percentage for categorical variables. The analysis of the treatment plan showed that methotrexate (MTX) was the most frequently prescribed conventional drug as first line therapy in 26 (87%) of the patients, in monotherapy. It was registered that only 5 (17%) of the analysed patients received CS DMARD in monotherapy and 25 (83%) in combination therapy. In our study group, the recommended treatment was considered effective in 53% of cases. One in three patients experienced adverse reactions to therapy. The most common adverse reactions were muco-cutaneous, followed by respiratory and digestive ones. The most prescribed CS DMARDs was MTX and the most used therapeutic strategy was step-up combination therapy. The initial treatment plan ensured the effective control of the disease in about half of RA patients. The adverse reactions of CS DMARDs agents were not of vital importance.