Iguratimod in combination with methotrexate in active rheumatoid arthritis

Xia, Zhenzhen; Lyu, Jinchun; Hou, Ningqi; Song, Lijun; Li, Xiao Xing; Liu, H

doi:10.1007/s00393-015-1641-y

Cited by 32 publications

(45 citation statements)

References 17 publications

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“…Two 24-week clinical studies both showed similar results. The group of IGU combined with MTX had better outcomes than that of MTX alone, such as Patient's clinical manifestations including joint tenderness and swollen joint count, pain visual analogue scale overall assessment of patients and physicians, ESR, CRP, health assessment questionnaire, DAS28, simplified disease activity index, and ACR 50 (P < 0.05) ( Table 2) (Duan et al, 2015;Xia et al, 2016). Interestingly, there was no significant difference in the incidence of adverse events between the IGU+MTX group and the MTX group (P > 0.05).…”

Section: Igu Combined With Other Drugs Igu Combined With Mtxmentioning

confidence: 99%

Iguratimod as a New Drug for Rheumatoid Arthritis: Current Landscape

Xie

Tian

et al. 2020

Front. Pharmacol.

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Iguratimod (IGU) is a novel synthetic small molecule disease modified anti-rheumatic drug approved only in Japan and China up to date. IGU plays an important immunomodulatory role in the synovial tissue of rheumatoid arthritis by inhibiting the production of immunoglobulins and cytokines and regulating T lymphocyte subsets. IGU also regulates bone metabolism by stimulating bone formation while inhibiting osteoclast differentiation, migration, and bone resorption. In clinical trials, IGU was shown to be superior to placebo and not inferior to salazosulfapyridine. Combined therapy of IGU with other disease-modifying anti-rheumatic drugs showed significant improvements for disease activity. IGU has good efficacy and tolerance as an additional treatment for rheumatoid arthritis patients with inadequate response to methotrexate and biological disease-modifying anti-rheumatic drugs. In this review, we summarize current landscape on the mechanism of action of IGU and its clinical effectiveness and safety. It is expected that further translational studies on IGU will pave the road for wider application of IGU in the treatment of autoimmune diseases other than rheumatoid arthritis.

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Section: Igu Combined With Other Drugs Igu Combined With Mtxmentioning

confidence: 99%

Iguratimod as a New Drug for Rheumatoid Arthritis: Current Landscape

Xie

Tian

et al. 2020

Front. Pharmacol.

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“…After subsequent screening, an additional 33 were excluded: 30 randomized controlled trials (RCTs) did not include the ACR20/50/70, 2 RCTs did not report adverse events, and 1 RCT was repeated in more than one bibliographic source. After the selection process, a total of 7 RCTs consisting of 665 participants with 368 participants in the active arm and 297 in the placebo arm were included in the meta-analysis [1,[16][17][18][19][20][21]. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram is included in .…”

Section: Search Resultsmentioning

confidence: 99%

“…Two studies [1,20] allowed the use of one NSAID (0.2 g celecoxib capsule, two times a day, oral) and (or) a small dose of a glucocorticoid (prednisone 7.5 mg/d or 10 mg/d), and two studies allowed the ), respectively (. Fig.…”

Section: Characteristics Of Participants Interventions and Comparator Details In The Included Studiesmentioning

confidence: 99%

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Efficacy and safety of iguratimod combined with methotrexate vs. methotrexate alone in rheumatoid arthritis

et al. 2020

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The current systematic review and meta-analysis aims to evaluate the efficacy and safety of iguratimod (IGU) combined with methotrexate (MTX) versus MTX alone in rheumatoid arthritis (RA). Two independent investigators searched for original randomized controlled trials (RCTs) related to the combination of IGU and MTX in RA published before November 1, 2019, in PubMed, Cochrane Library, Embase, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), and WanFang Data. Additionally, we searched clinical trial registry websites. We assessed the methodological quality of the included trials using the Cochrane Collaboration tool and the seven-point Jadad scale. Statistical analyses were performed using Review Manager (RevMan) 5.3 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Meta-regression and publication bias analyses were performed using Stata version 14 software (StataCorp., College Station, TX, USA). A total of 7 RCTs consisting of 665 participants, with 368 participants in the active arm and 297 in the placebo arm, were included in the meta-analysis. The American College of Rheumatology (ACR) value was better in the IGU + MTX group than in the MTX alone group, with a pooled relative risk (RR) for ACR20 (American College of Rheumatology 20% improvement criteria), ACR50, and ACR70 of 1.40 (95% CI, 1.13–1.74), 2.09 (95% CI, 1.67–2.61), and 2.24 (95% CI, 1.53–3.28), respectively. The results of the meta-analysis demonstrated that there was no statistical significance in adverse events (1.06 (95% CI, 0.92–1.23)). The combined treatment is an effective, safe, and economical treatment option for patients who do not respond well to methotrexate alone or for patients who cannot afford expensive biologics that have no confirmed efficacy.

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“…Recently, Xia et al studied 131 Chinese patients with active RA who had previous exposure to other DMARDs. 75 The authors found that iguratimod combined with MTX had a significant synergistic effect on RA amelioration compared with MTX alone, whereas iguratimod alone was also efficient. The dose used was 25 mg twice a day orally for iguratimod and 10 mg weekly for MTX.…”

Section: Introductionmentioning

confidence: 99%

Iguratimod: a valuable remedy from the Asia Pacific region for ameliorating autoimmune diseases and protecting bone physiology

Bao²,

Zeng³

et al. 2019

Bone Res

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Autoimmune diseases are affected by complex pathophysiology involving several cell types, cytokines, antibodies, and mimicking factors. Different drugs are used to ameliorate these autoimmune reactions, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antiantibodies, and small molecular drugs (DMARDs), and they are clinically in vogue for diseases such as rheumatoid arthritis (RA). Nevertheless, low cost-effectiveness, reduced efficacy, adverse effects, and patient nonresponse are unappealing factors driving the development of new drugs such as iguratimod. Iguratimod is primarily used to ameliorate RA in Japanese and Chinese clinics. However, its efficacy against other autoimmune ailments is also under intense investigation, and the number of investigations is becoming increasingly larger with each passing day. The articular structure comprises synovium, ligaments, and bone. The latter is more complex than the others since it regulates blood cells and autoimmunity in addition to providing skeletal support to the body. Therefore, its protection is also of prime importance in RA and other autoimmune diseases. Herein, we have highlighted the role of iguratimod in autoimmune diseases and bone protection. We suggest that iguratimod's unique mode of action compared with that of other DMARDs and its good patient response makes it a suitable antirheumatic and bone-protecting drug.Bone Research (2019) 7:27 ; https://doi.Fig. 2 Effects of iguratimod and other DMARDs on collagen-induced arthritis. a Arthritis score in different DMARD-treated groups. b Arthritis incidence of different treated groups. c The extent of paw edema in various groups. d The body weight measured in various groups after DMARD treatment. e X-ray radiographs of various groups treated with different DMARDs. Arrows indicate the bone erosion area, whereas * and ** indicate significance P-values of <0.05 and 0.01 (*P < 0.05, **P < 0.01), respectively. Adapted from Ref. 21

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Iguratimod in combination with methotrexate in active rheumatoid arthritis

Cited by 32 publications

References 17 publications

Iguratimod as a New Drug for Rheumatoid Arthritis: Current Landscape

Iguratimod as a New Drug for Rheumatoid Arthritis: Current Landscape

Efficacy and safety of iguratimod combined with methotrexate vs. methotrexate alone in rheumatoid arthritis

Iguratimod: a valuable remedy from the Asia Pacific region for ameliorating autoimmune diseases and protecting bone physiology

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