Early, structured disease modifying anti-rheumatic drug (DMARD) therapy reduces cardiovascular risk in rheumatoid arthritis--a single centre study using non-biologic drugs

J Assoc Physicians India. 2013 Aug;61(8):531-4.


Background: Rheumatoid arthritis, being a chronic disease requires long-term management of patients with drugs. The increasing cost of biologics in this era of disease management led us to devise a treatment regime, optimal for use in a developing country like India, which was economical as well as effective in controlling disease activity.

Objective: To investigate if combination therapy with DMARDs can reduce cardiovascular risk in early Rheumatoid Arthritis, besides controlling disease activity.

Methods: A small cohort of early Rheumatoid subjects with disease duration less than 1 year were treated with a structured DMARD regime and were followed up over a year. Disease activity score, C-reactive protein (CRP) and cardiac risk markers like lipid panel and carotid intima-medial thickness were monitored at 6 months and 1 year.

Results: A significant reduction (p < 0.001) of disease activity as well as cardiac risk parameters were observed.

Conclusion: Our study showed that treatment of early rheumatoid arthritis with a combination regime of traditional DMARDs is highly effective in controlling disease activity as well as cardiovascular risk.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy*
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Carotid Intima-Media Thickness
  • Cholesterol / blood
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydroxychloroquine / administration & dosage
  • Isoxazoles / administration & dosage
  • Leflunomide
  • Male
  • Methotrexate / administration & dosage
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Severity of Illness Index
  • Sulfasalazine / administration & dosage
  • Triglycerides / blood
  • Young Adult


  • Antirheumatic Agents
  • Isoxazoles
  • Triglycerides
  • Sulfasalazine
  • Hydroxychloroquine
  • C-Reactive Protein
  • Cholesterol
  • Leflunomide
  • Methylprednisolone
  • Methotrexate