Suarez-Almazor M E, Soskolne C L, Saunders L D, Russell A S
Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada.
J Rheumatol. 1995 May;22(5):836-43.
Our purpose was to compare the patterns of prescription of 2nd line drugs for the treatment of rheumatoid arthritis (RA) among rheumatologists in Edmonton, Alberta, and to examine the longterm effectiveness of these drugs.
A 1985 inception cohort of 128 patients with RA was assessed between 1991 and 1992, using measures of disease activity, radiological scores and physical functional status. Use of different therapies was retrieved from the medical charts.
All patients had seen a rheumatologist at any time between January, 1985 and December, 1991, 88% within the first 3 years of disease. Most (85%) had received at least one 2nd line drug, the majority within the first 2 years. Overall, gold salts were the most frequently prescribed drugs. Patterns of prescription varied among different rheumatologists; some drugs were never prescribed by some and very often by others (e.g., auranofin). Terminations because of toxicity and lack of efficacy were high. Methotrexate (MTX) had the lowest termination rate and sulfasalazine the highest, mostly due to lack of efficacy.
In this cohort, patients were treated early in the course of RA. Patterns of prescription of 2nd line drugs varied among rheumatologists. Termination rates were highest for sulfasalazine and lowest for MTX.
我们的目的是比较阿尔伯塔省埃德蒙顿市风湿病专家治疗类风湿关节炎（RA）的二线药物处方模式，并研究这些药物的长期疗效。
1991年至1992年期间，对1985年开始纳入队列的128例RA患者进行评估，采用疾病活动度、放射学评分和身体功能状态等指标。从病历中获取不同治疗方法的使用情况。
所有患者在1985年1月至1991年12月期间均曾就诊于风湿病专家，88%在疾病的前3年内就诊。大多数（85%）患者至少接受过一种二线药物治疗，多数在疾病的前2年内。总体而言，金盐是最常处方的药物。不同风湿病专家的处方模式各不相同；有些药物一些专家从未处方过，而另一些专家则经常处方（例如，金诺芬）。因毒性和缺乏疗效而停药的比例较高。甲氨蝶呤（MTX）的停药率最低，柳氮磺胺吡啶的停药率最高，主要是因为缺乏疗效。
在这个队列中，患者在RA病程早期就接受了治疗。二线药物的处方模式在风湿病专家之间存在差异。柳氮磺胺吡啶的停药率最高，MTX的停药率最低。
