Hydroxychloroquine sulphate in the treatment of rheumatoid arthritis: a double blind comparison of two dose regimens

Article Abstract:

Rheumatoid arthritis (RA) is a joint disease characterized by inflammation of the joints, stiffness, swelling, enlargement of the cartilage, and pain. The drug hydroxychloroquine, used to treat RA for more than 30 years, decreases disease activity by 30 percent in 63 percent of patients. Although hydroxychloroquine is less effective than other anti-rheumatic agents, such as gold and penicillamine, it is better tolerated than these other two drugs. The most severe complication of hydroxychloroquine treatment is the development of retinopathy, a disease of the retina which is the inner lining of the eye. The development of retinopathy from hydroxychloroquine is dose-dependent and does not occur with daily doses of 200 milligrams (mg). The effects of two doses, 200 mg and 400 mg, of hydroxychloroquine were examined in 54 RA patients with moderate disease activity; 43 patients completed the one-year treatment. Both dose regimens were effective and reduced disease activity within one year of treatment; there were no differences noted between the two doses in clinical or laboratory measurements. However, patients receiving 400 mg of hydroxychloroquine had three times more side effects than patients receiving only 200 mg of the drug. These findings indicate that the 200 mg dose of hydroxychloroquine is the preferable for providing safe and effective treatment for RA. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration

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A double blind comparative study of sulphasalazine and hydroxychloroquine in rheumatoid arthritis: evidence of an earlier effect of sulphasalazine

Article Abstract:

The effects of the drugs sulphasalazine (2 grams daily) and hydroxychloroquine (400 milligrams daily) on rheumatoid arthritis, a disease which causes inflammation and stiffness of the joints, were studied in 60 patients. The patients responded faster to sulphasalazine than to hydroxychloroquine. After 11 months, a comparison of the effects of the two drugs revealed no significant difference in disease activity. Adverse reaction was the main reason for patients' withdrawl from the sulphasalazine group, and lack of effect was the main reason for withdrawl from the hydroxychloroquine group. All adverse reactions, including agranulocytosis (decline in the number of certain types of disease-fighting white blood cells), appeared during the first three months of treatment and were completely reversible.

Joint diseases

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Combination therapy in early rheumatoid arthritis: a randomised, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components

Article Abstract:

Combination drug therapy may possibly be more effective than single drug administration in treatment of rheumatoid arthritis, any relative superiority is not enough to be clinically important. In either method, early treatment seems advisable and beneficial. A total of 205 patients being treated for rheumatoid arthritis were divided into three groups receiving either methotrexate, sulfasalazine, or a combination of both. All three methods were equally well tolerated as regards side effects, but the slight improvement in some outcomes of the patients using the combination of drugs was not enough to consider significant.

Evaluation, Drug therapy, Combination, Combination drug therapy, Methotrexate

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