Drug Combos Effective Against Rheumatoid Arthritis

Donahue recommended that patients talk to their doctors about developing a treatment plan that is tailored to their individual condition. "Rheumatoid arthritis is very patient-specific -- there are many therapies, and there doesn't appear to be one therapy that is clearly superior," she said. "It's a conversation between you and your rheumatologist about what might be right for you."

One expert said the study will be useful for physicians.

"This is a great summary about what we know about how DMARDs work," said Dr. Steven Vlad, a fellow in rheumatology at Boston University Medical Center. "That basic finding -- that one synthetic of biologic doesn't work any better than others -- is a good thing to remind ourselves of," he said.

Some doctors think that biologics work better, Vlad said. "But that's not the case. All these drugs seem to work equally as well," he said.

Combination therapy can be effective, Vlad said, but biologics should be the last choice. "Methotrexate is what most doctors are going to go with first," he said. "You start with methotrexate. If that doesn't work, you add another synthetic drug; if that doesn't work, maybe then you go to a biologic," he said.

More information

For more on rheumatoid arthritis, visit the Arthritis Foundation.

SOURCES: Katrina E. Donahue, M.D., M.P.H., assistant professor, department of family medicine, University of North Carolina, Chapel Hill; Steven Vlad, M.D., fellow, rheumatology, Boston University Medical Center; Nov. 20, 2007,Annals of Internal Medicine