Methotrexate versus chloroquine in the treatment of rheumatoid arthritis

Abstract

Aims: The cost of treatment and monitoring of rheumatoid arthritis patients with more effective disease‐modifying drugs like methotrexate and sulphasalazine is prohibitive. This open random clinical trial was carried out with a view to assessing the status of chloroquine, the cheapest disease‐modifying drug, in the treatment of rheumatoid arthritis. Method: A total of 47 cases were included in the study. Thirty subjects were randomly assigned to methotrexate and 14 to chloroquine groups. During 6 months follow‐up, five cases (three in chloroquine and two in methotrexate) dropped out because of side‐effects and inefficacy. Out of the remaining 42, 35 were female and five were male, with a mean age of 46.05 ± 14.12 years. Mean duration of the disease at the time of presentation was 5.53 ± 6.33 years. The two groups did not differ significantly in baseline demographics and disease activity variables. Results: In both groups, most indices showed significant decrease in the disease activity. The difference in decreases in swollen joint count, tender joint count, joint swelling index and duration of morning stiffness were higher in the methotrexate compared to the chloroquine group. Inter‐group differences in the magnitudes of decreases were insignificant in other variables. At the end of 6 months, the response rate, according to the WHO/ILAR criteria, were 75% and 64% in methotrexate and chloroquine groups, respectively. The difference was not significant. Anorexia and nausea were the most common side‐effects in both groups and subsided with the passage of time despite continuation of therapy. Conclusion: Considering low cost and a lesser need for close monitoring, chloroquine may be considered a choice in rheumatoid arthritis patients with mild disease and who are from underprivileged communities.

Hydroxychloroquine ameliorates dasatinib-induced liver injury via decrease in hepatic lymphocytes infiltration

“…It shows a safe and effective profile not only towards malaria infection but also against autoimmune diseases such as lupus erythematosus and rheumatoid arthritis. 16,17 Also, HCQ is shown to exert activity against different diseases such as cancer, type 2 diabetes, and autoimmune disease. 18 Recently, HCQ was primitively administered to manage patients with COVID-19 infection despite several studies showing no effects of HCQ against COVID-19 as compared to placebo.…”

Evidence‐based recommendations for the diagnosis and management of rheumatoid arthritis for non‐rheumatologists: Integrating systematic literature research and expert opinion of the Thai Rheumatism Association

“…However, for which DMARD should be the first one, our systematic review identified six RCTs comparing the efficacy and safety between these DMARDs . Although MTX was slightly more effective than SSZ and CQ, more patients in the MTX group experienced nausea, vomiting, hepatitis, and oral ulcers. SSZ was more effective than HCQ, but it was not significant …”