A rheumatoid Ahritis patient on Methotrexate, steroids and NSAIDs for past 4 months has had no retardation of disease progression. What is the next rational step in management?
Correct Answer: Add Sulfasalazine
Description: For patient with RA, Steroid and NSAIDS one given for symptomatic relief. Methotrexate used alone or in combination therapy has become a mainstay of treatment in patient with RA or psoriatic ahritis. Methotrexate is a folic acid antagonist that inhibits cytokine production and purine nucleotide biosynthesis leading to immunosuppressive and anti-inflammatory effects. If methotrexate alone is not working, We add sulfasalazine, If it still doesn't work, we give triple therapy which are:- Methotrexate Sulfasalazine Hydroxychloroquine/ Leflunomide If triple therapy doesn't work, we Sta INF inhibitor.
Category:
Pharmacology
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