Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 4

The Ratio of Second-Line Drug Usage Time to Disease Duration and Reasons for Drug Cessation in Rheumatoid Arthritis Patients

Reyhan Tuncay 1 ,Emel Ekşioğlu 2 ,Eda Gürçay 3 ,Aytül Çakcı 4
1 Sağlık Bakanlığı Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
2 Clinic of Physical Medicine and Rehabilitation, Etlik İhtisas Training and Research Hospital, Ankara, Turkey
3 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara, Türkiye
4 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye

Objective: The aim in the treatment of rheumatoid arthritis (RA) is to reduce disability and articular destruction to a minimum with the help of disease modifying anti-rheumatic drugs (DMARDs). However, their efficacy and side effects profile may limit the usage of these drugs. 
 

Materials and Methods: In this study, DMARDs usage ratio was calculated by dividing total drug usage time (month) by disease duration (month). The side effects and reasons for drug cessation were investigated in 85 RA patients. 
 

Results: Sulfasalazine was determined as the drug used for the longest period (27%) during the disease duration. Sulfasalazine and antimalarial drugs were stopped for their ineffectiveness at rates of 35.7% and 47.8%, respectively. Methotrexate was stopped for gastrointestinal intolerance (36.4%), cyclosporin for nephrotoxicity (71.4%), leflunomide for hematologic side effects and hepatotoxicity (37.5%), and gold salts due to unavailability (70.8%). 
 

Conclusion: Drugs having maximum efficacy and minimum side effects are still needed in rheumatoid arthritis treatment. 
 

Keywords : Rheumatoid arthritis, disease modifying anti-rheumatic drugs, side effects