Iguratimod as monotherapy or Combined therapy in patients wi
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This study aims to evaluate the efficacy and safety of the iguratimod (IGU) as monotherapy or combined therapy in patients with rheumatoid arthritis (RA) by using meta-analysis.

The risk of bias in individual studies was assessed using the Cochrane Risk of Bias tool. STATA 12.0 was used for pooled analysis of all included studies.

Results:
A total of 23 RCTs were included in this analysis.

--Meta-analysis showed that patients in the IGU monotherapy or combined therapy group had significantly higher ACR20 (OR = 1.97), lower DAS28-CRP (SMD = -3.49) and DAS28-ESR (SMD = -2.61), as well as shorter duration of morning stiffness (SMD = -2.06) and lower HAQ score (SMD = -0.91), than those received other disease-modifying antirheumatic drugs (DMARDs) monotherapy (primarily comprising methotrexate).

--For the safety profile, IGU monotherapy had similar risks for gastrointestinal reactions, leucopenia, increment in transaminase, increase of ALT, and liver damage to methotrexate monotherapy, and IGU combined with other DMARDs therapy did not increase the risks of these AEs.

In conclusion, IGU as monotherapy or combination therapy, especially methotrexate, is effective and tolerating in individuals with active RA. In combination with others DMARDs for the treatment of RA, IGU can be considered to be a potential option for methotrexate.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02603-2
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