Efficacy analysis of diacerein in combination with methotrexate and leflunomide in the treatment of rheumatoid arthritis in elderly patients
10.3760/cma.j.issn.0254-9026.2014.07.023
- VernacularTitle:双醋瑞因联合甲氨蝶呤和来氟米特治疗老年人类风湿关节炎的疗效分析
- Author:
Dan HAN
- Publication Type:Journal Article
- Keywords:
Arthritis,rheumatoid;
Rhein;
Methotrexate
- From:
Chinese Journal of Geriatrics
2014;33(7):775-778
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical efficacy of diacerein plus methotrexate and leflunomide in the treatment of rheumatoid arthritis in elderly patients.Methods Eighty elderly patients with rheumatoid arthritis seeking treatment at our hospital from September 2010 to December 2012 were divided into the treatment group (n =40) and the control group (n =40).Patients with osteoarthritis were excluded from enrollment.The treatment group was given diacerein,in addition to methotrexate and leflunomide,whereas the control group received methotrexate and leflunomide.Results Compared with the control group,the treatment group showed a lower swollen joint count [(0.93±0.21) vs.(3.43±0.69),t=10.728,P=0.013],a lower tender joint count [(1.15±0.46)vs.(3.6110.83),t=11.443,P=0.008],shorter morning stiffness (1.6±2.2 min vs.13.5±4.2min,t=11.164,P=0.011),and greater hand grip strength [7.97±1.53) kPa vs.(5.68±2.07)kPa,t=10.562,P=0.014].When measured by health assessment questionnaire (HAQ),visual analogue scale (VAS) and DAS28 scores,the treatment group also performed better than the control group.Additionally,the treatment group displayed a more favorable laboratory profile,which included the erythrocyte sedimentation rate (ESR) (9.51±4.32 mm/h vs.26.47±6.32 mm/h,t=9.892,P=0.028),C-reactive protein (CRP) [(2.34±0.57) mg/L vs.(8.13±2.14) mg/L,t=9.427,P=0.031],and rheumatoid factors (RF) [(231.3±45.5) kU/L vs.(283.3±68.4) kU/L,t=10.023,P=0.018].Furthermore,the adverse reaction rate was significantly lower in the treatment group than in the control group (15.0% vs.37.5%,x2 =5.230,P=0.020).Conclusions Diacerein in combination with methotrexate and leflunomide has shown clearly positive outcomes in the treatment of rheumatoid arthritis in elderly patients and should be recommended in clinical treatment.