Outcomes of Treating Rheumatoid Arthritis with Combination Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs Therapy: A Hospital Database in Real-World Data

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease with limited treatment options in real-world settings. The present study objective was to evaluate treatment response rates and associated complications, considering some limitations in available treatments. Materials and Methods: A retrospective analytical study was conducted on RA patients at the Internal Medicine Department, Khon Kaen Hospital, between January 2015 and May 2022. Results: Seven hundred twenty-one RA patients were included, of which 118 patients, or 16.37%, were treated with four types of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). At 24 weeks, the patients with the four types of csDMARDs treatment had remission and low disease activity by DAS28-ESR more than in whom received one to three types of csDMARDs, which is 67.80% versus 35.82%. The findings were also similar to the categorization of disease activity using DAS28-CRP, which was 83.90% versus 80.10%. When compared to baseline, mean DAS28-ESR and mean DAS28-CRP were significantly different in both 12 weeks and 24 weeks in both groups. The adverse events in the patients with one to three types of csDMARDs treatment and four types of csDMARDs treatment was 5.80% versus 11.24%, respectively. Conclusion: RA patients treated with a combination of csDMARDs showed positive results, with 35.82% achieving treatment targets using one to three types and 67.80% achieving targets with four types, all with minimal increase in complications.