What are the Agency for Healthcare Research and Quality (AHRQ) recommendations for the pharmacologic therapy of rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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A 2007 clinician’s guide from the Agency for Healthcare Research and Quality (AHRQ) advised the following, with a medium level of confidence [6] :

  • For patients with early RA (< 3 years’ duration) who have not previously taken methotrexate (MTX), monotherapy with MTX controls symptoms as well as monotherapy with adalimumab or etanercept

  • Combining a biologic agent with MTX brings better symptom relief than using either agent alone

  • For patients with early RA, the combination of MTX and sulfasalazine (SSZ) does not work better than monotherapy with either drug

  • Evidence is insufficient to determine whether combining 2 biologic agents works better than using any 1 biologic agent alone; in addition, concomitant use of 2 biologic agents has been associated with an increased risk for complications without clear improved benefit

  • MTX and most biologic agents increase the likelihood of serious infection

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