Outcomes Associated With Methotrexate, Sulfasalazine, and Hy
A Study was conducted to demonstrate relatively comparable clinical outcomes with triple therapy (methotrexate [MTX], sulfasalazine [SSZ], and hydroxychloroquine [HCQ]).

The clinical effectiveness and effects of medication discontinuation of triple therapy with MTX/SSZ/HCQ versus combination therapy with TNFi/MTX in rheumatoid arthritis (RA) patients were evaluated. Propensity score matching was used to match patients up to a ratio of 1:3 to adjust for imbalances between treatment groups, with stratification performed according to biologics-naive or biologics-exposed status of study participants.

--Patients eligible for analysis in this study included biologics-naive RA patients and biologics-exposed RA patients.

--Before propensity score matching, numerous factors were imbalanced between the treatment groups, with triple therapy patients generally being older, having a longer disease duration of RA and lower RA disease activity, and more likely having a history of malignancy and other comorbidities.

--After matching, almost all (93–98%) triple therapy patients could be matched to TNFi/MTX therapy patients, and cohort characteristics were generally well balanced.

--Discontinuation of medication was greater in triple therapy patients referent to TNFi/MTX therapy patients.

--At 6 months, the proportion of biologics-naive patients attaining low disease activity was significantly greater in the TNFi/MTX treatment group, as was the mean change in Clinical Disease Activity Index scores.

--Corresponding results in the biologics-exposed patients numerically favored TNFi/MTX therapy compared to triple therapy but did not reach statistical significance.

In the present study, drug persistence and clinical effectiveness outcomes were less favorable in triple therapy patients compared to TNFi/MTX therapy patients.

Source: https://onlinelibrary.wiley.com/doi/10.1002/acr.24253?af=R