Clinical Edge Journal Scan

Can iguratimod be regarded as a potential alternative to methotrexate in RA?


 

Key clinical point: Iguratimod as monotherapy or combined therapy was remarkably effective and safe in patients with active rheumatoid arthritis (RA) compared with other disease-modifying antirheumatic drugs (DMARDs) monotherapy, primarily consisting of methotrexate.

Major finding: Compared with other DMARDs monotherapy, iguratimod monotherapy or combined therapy was associated with significantly higher American College of Rheumatology 20% response (odds ratio, 1.97; P = .002), lower Disease Activity Score in 28 joints-C-reactive protein (standard mean difference [SMD], 3.49), and a shorter duration of morning stiffness (SMD, 2.06; all P less than .001). The incidence of gastrointestinal events ( P = .070), leucopenia ( P = .309), transaminase elevation ( P = .321), and liver damage ( P = .182) was comparable between methotrexate and iguratimod monotherapy.

Study details: This was a meta-analysis of 23 randomized clinical trials involving 2,533 patients with RA.

Disclosures: This study was supported by the Ministry of Science and Technology of China, the Chinese Academy of Medical Sciences, and the Beijing Municipal Science & Technology Commission. The authors declared no conflict of interests.

Source: Hu CJ et al. J Orthop Surg Res. 2021 Jul 16. doi: 10.1186/s13018-021-02603-2 .

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