Efficacy and Safety of Conventional Synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs) on the treatment of Rheumatoid Arthritis

Abstract

Introduction: Rheumatoid arthritis is a systemic disease that can induce a wide range of extra- articular
symptoms. CsDMARDs–methotrexate, hydrochloroquine, leflunomide, and sulfasalazine are a few beneficial
remedies for RA. DMARDs are a mainstay in the management of rheumatoid arthritis. Objective- To assess
the efficacy of Conventional Synthetic DMARDs on the treatment of Rheumatoid Arthritis. Methodology: A
total 36 patients of Rheumatoid Arthritis fulfilling the inclusion criteria and having symptoms of RA were
enrolled for this Interventional study from OPD of Department of Medicine, SS Hospital, Institute of Medical
Sciences, BHU, Varanasi and were followed for three months. After the completion of the study, 32 patients
completed all 3 follow-ups. Result: DMARDs has significantly improved the RA factor, Anti CCP, CRP and
ESR values, as median values of these diagnostic tests have reduced over time (RA factor- 27.12 to 16.24,
Anti CCP- 28.26 to 18.86, CRP – 7.65 to 4.23 and ESR- 34.50 to 23.50). After 3 months treatment with
synthetic DMARDs, the mean SGOT, SGPT and Urea level decreased significantly from 36.43 ± 12.92 to
31.93 ± 10.92, 38.74 ± 12.15 to 34.01 ± 10.59 and 39.14 ± 12.34 to 34.51 ± 10.44 respectively. DMARDs
was also effective in reducing the pain (joint pain, low back pain and neck pain),as median values of joint
pain, low back pain and neck pain have reduced over time (Joint pain- 6 to 3, Low Back Pain- 6 to 2 and Neck
Pain- 4.5 to 1). Adverse effects were observed in more than 30% of patients Discussion: The study showed
that DMARDs was effective and safe for the treatment of Rheumatoid Arthritis according to the biochemical
and clinical pain score finding over -90 day follow up. A long term follows up and histological examination,
invasive or non – invasive, is required to give conclusive report.