الفهرس 
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Abstract
Purpose: Investigating the efficacy and safety of rupatadine (RUP) versus montelukast (MON) as adjuvant therapy for patients with rheumatoid arthritis (RA). Methods: from December 2018 to December 2019, 75 patients with RA were enrolled in this randomized controlled parallel study. The patients were randomized into three groups (n=25 in each group); methotrexate (MTX) group which received MTX 15-25 mg/week subcutaneous; MTX/RUP group which received MTX plus RUP 10 mg once daily and MTX/MON group which received MTX plus MON 10 mg once daily. The treatment duration was three months. At baseline and three months after treatment, blood samples were collected for biochemical analysis of high sensitivity C-reactive protein (hs-CRP), interleukins 8 & 17 (IL-8, IL-17), E-selectin and clusterin (CLU) serum levels. Clinical & functional assessments using disease activity score-CRP (DAS28-CRP) and multidimensional health assessment questionnaire (MDHAQ) were also performed. Results: Both RUP and MON produced clinical and functional improvements which were translated by significant improvements in DAS28-CRP score and MDHAQ. Rupatadine significantly reduced all measured parameters (p<0.05) except for IL-17 & CLU. Montelukast significantly decreased all measured variables (p<0.05) except for E-selectin. Interleukin-8 was positively and significantly correlated with IL-17 & CLU, while hs-CRP was positively and significantly correlated with E-selectin & body mass index (BMI). Both drugs were well tolerated; somnolence was the common side effect for RUP. No neuropsychiatric events were reported with MON group. Conclusion: Rupatadine and montelukast may serve as potential adjuvant therapies for patients with rheumatoid arthritis secondary to the preliminary evidence of efficacy and safety. Clinical Trial.gov Identifier: NCT03770923, December 10, 2018 Keywords: Rheumatoid Arthritis, Montelukast, Rupatadine, C-Reactive Protein, Platelet Activation Factor, Dose-Dependent Effect.