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  Česky / Czech version Čes. Revmatol., 9, 2001, No. 1, p. 3–13.
 
Analysis of Reasons for Discontinuation of DMARDs in Patients with Rheumatoid Arthritis 
Forejtová Š., Pavelková A., Zvárová J. 1 , Rovenský J. 2 , Tuchyňová A. 2 , 

Revmatologický ústav, Praha 1 Evropské centrum pro medicínskou informatiku, statistiku a epidemiologii UK a AV ČR, Praha 2 Výskumný ústav reumatických chorôb, Piešťany
 


Summary:

       The authors performed an epidemiological study which evaluated treatment of rheumatoid arthritis by different disease modifying drugs (DMARDs) from the aspect of effectiveness and toxicity. It was a retrospective multicentre trial where the documentation of 15 rheumatological out- an in-patient departments in the Czech and Slovak Republic was used. Based on this documentation the physician completed a questionnaire which was processed by computer. A total of 1162 cases of discontinued DMARDs therapy in 760 patients with RA was recorded. Discontinuation of therapy on account of side effects was recorded most frequently in gold therapy and in treatment with methotrexate (in both some 60% of documented cases discontinued treatment). The least frequent discontinuation for side effects was found with antimalarial drugs (less than 25 %). On the other hand, due to the insufficient effectiveness, the antimalarials were discontinued most frequently (66 %), whereas cyclophosphamide discontinuation was observed in the least number of cases (less than 20 %). The mean period of DMARDs therapy was almost 30 months. It is surprising that cyclophosphamide was administered for the longest period (mean 39 months). Cyclosporin was administered for the shortest period (mean 9 months). The period of treatment correlated significantly with the patient’s age at the time when treatment was started, with the positivity of the rheumatoid factor, extraarticular symptoms and the patient’s education. Conversely no relationship was found between the period of DMARDs administration and other factors such as sex, sedimentation rate, concurrent corticoid administration.

        Key words: rheumatoid arthritis, treatment, disease modifying drugs, DMARDs, side effects, inadequate effectiveness
       

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