Effect of combined treatment with Methotrexate and Non-steroidal anti-inflammatory drugs on plasma alpha-tocopherol level and Rheumatoid factor among Rheumatoid Arthritis patients
DOI:
https://doi.org/10.3329/mediscope.v8i2.55314Keywords:
Methotrexate, NSAIDs, Rheumatoid Arthritis, Alpha-tocopherol, Oxidative stress, Rheumatoid factorAbstract
Background: Oxidative stress might play a significant role in the pathogenesis of Rheumatoid Arthritis. Traditional therapies of Rheumatoid Arthritis are governed by different NSAIDs which improve symptoms of Rheumatoid Arthritis. But addition of Methotrexate (MTX) to Non-steroidal anti-inflammatory drugs (NSAIDs) has been found to be extra beneficial by halting the disease process.
Objectives: To evaluate the status of anti-oxidant alpha-tocopherol and rheumatoid factor before and after treatment with MTX and NSAIDs for two months in Rheumatoid Arthritis patients.
Methods: This quasi-experimental study was carried out in the Department of Pharmacology and Therapeutics of Rajshahi Medical College, Rajshahi between the periods of January 2011 to December 2011. Total ten clinically diagnosed Rheumatoid Arthritis patients were enrolled in the study. Purposive sampling technique was used to select each study subject from medicine wards of Rajshahi Medical College Hospital. Alpha-tocopherol, an anti-oxidant in plasma was measured as marker of anti-oxidant defense. The patients were then treated with oral MTX at a dose of 10 mg weekly and Indomethacin 150 mg in three divided doses daily for 2 months. After 2 months of continuous aforementioned treatment, alpha-tocopherol levels were estimated again. Moreover qualitative assessment of rheumatoid factor was done. For statistical analysis, paired t-test was done.
Results: After two months of treatment with Methotrexate and Indomethacin, plasma alpha-tocopherol levels were significantly higher (P<0.05) in Rheumatoid Arthritis patients. However no significant change was observed in qualitative assessment of rheumatoid factors.
Conclusion: From the findings of this study, it can be concluded that the endogenous alpha-tocopherol level increases even without any supplementation of alpha-tocopherol by combined treatment with MTX and Indomethacin in Rheumatoid Arthritis patients and thereby reduces oxidative stress. So alpha-tocopherol level is a better marker for early assessment of prognosis of Rheumatoid arthritis than Rheumatoid factor test.
Mediscope 2021;8(2): 80-86
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Copyright (c) 2021 F Pervin, MA Habib, N Ahmed, MMR Sardar
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