Efficacy Observation of Penicillamine and Low Dose of Glucocorticoids with Etanercept in the Treatment of Rheumatoid Arthritis

OBJECTIVE:To observe the effectiveness and safety of penicillamine and low dose of glucocorticoids with etanercept(ETA) in the treatment of rheumatoid arthritis(RA).METHODS:56 cases of RA were randomly divided into 2 groups,28 cases in the control group were given daily oral dose of penicillamine 300 mg+prednisone 10 mg once a day,4 weeks later decreasing to 5mg.The experimental group was given enalapril based on control group,subcutaneous injection twice a week,each time 25 mg.The treatment course lasted for 3 months.The therapeutic efficacy was evaluated by American College of Rheumatology(ACR) standard.RESULTS:After 6 and 12 weeks of treatment,the laboratory index and the clinical symptoms of experimental group and control group were improved,the effective rate of 20% improvement of ACR standard(ACR20) were 21.4% and 46.4%,39.3% and 64.3%(P0.05).The changes of disease activity score(DAS28) were compared between 2 groups before and after treatment.Compared with before treatment,DAS28 of patients in the experimental group had decreased significantly at 6 week(P0.05).The most common adverse reactions of experimental group were mainly injection-site reactions,upper respiratory tract infection and gastrointestinal tract reaction;that of control group mainly rash reaction.CONCLUSION:Etanercept is effective and safe in the treatment of RA,can shorten the duration of disease remission.