Combination Therapy with Cyclosporine and Methotrexate in Severe Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, recurrent inflammatory disease that leads to substantial disability, loss of productivity, and increased mortality. 1 – 3 The traditional 4 approach to drug treatment emphasizes the stepped use of one medication at a time. When first-line agents such as aspirin and other nonsteroidal antiinflammatory drugs fail, slow-acting antirheumatic drugs such as methotrexate, antimalarial agents, gold salts, penicillamine, or sulfasalazine are considered. Patients treated with cyclosporine, a recent addition to this list, have improvement of similar magnitude to that of patients given other slow-acting agents. 5 Monotherapy for rheumatoid arthritis is being reconsidered because of dissatisfaction with its effects, 6 – . . .