OBJECTIVE: To evaluate the tolerability and efficacy of @entity1499 ( @entity1500 ) treatment in @entity1 with longstanding, progressive, active @entity309 ( @entity309 ) who had failed one or more disease modifying antirheumatic drugs (DMARD). METHODS: Two hundred seventy-one consecutive @entity1 with @entity309 in whom @entity1500 treatment was introduced were followed at regular intervals for up to 108 months. Evaluations included the number of swollen joints, grip strength, @entity1 assessment of @entity158 and mobility, erythrocyte sedimentation rate (ESR), and hemoglobin. Radiographs of hands and feet were taken once a year and 32 joints were evaluated according to a modified Larsen score. RESULTS: Of the 271 @entity1 , 269 had prior treatment with one DMARD, primarily parenteral gold, and 58% with 2 or more DMARD. @entity1500 was started parenterally in all @entity1 in doses between 15 and 25 mg weekly and continued by oral medication in most of the cases. Eighty-three percent of @entity1 complained of adverse events. The most common side effects were @entity390 , hair loss, transaminase increase, and @entity3136 . In 45 @entity1 (16.5%), @entity1500 was withdrawn because of side effects, mostly during the first year. Sixteen @entity1 (5.9%) died during followup, mainly due to @entity583 , @entity712 , @entity64 , or @entity5 . After one year, 78.7% and after 5 years 60.3% of the @entity1 were still taking @entity1500 . Number of swollen joints, ESR, grip strength, @entity1 assessment of @entity158 , and mobility improved significantly at all measurement points. Improvement in the swollen joint count and the ESR of over 50% was seen in more than 50% of @entity1 . @entity66 , defined as < 2 swollen joints, ESR < 20 mm, and no concomitant @entity134 use, occurred in 8-14% of @entity1 . @entity134 intake was significantly reduced. In spite of clinical improvement the modified Larsen score showed a progression in the vast majority of @entity1 . CONCLUSION: Even in @entity1 with longstanding, active, destructive @entity309 who failed one or more DMARD, @entity1500 treatment is well tolerated and improves clinical and biochemical disease activity significantly, while radiographic progression is still present.

Long-term treatment of destructive @entity309 with XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity390 :: ('MESH:D009325', 'Disease') :: ['nausea'] @entity3136 :: ('MESH:D013280', 'Disease') :: ['stomatitis'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity66 :: ('MESH:D004194', 'Disease') :: ['Inactivation of the disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid', 'Steroid'] @entity1500 :: ('CHEBI:44185', 'Chemical') :: ['MTX'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['methotrexate'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis', 'RA']
@entity1499 :: (MESH:D008727,Chemical) :: ['methotrexate']
