Abstract
OBJECTIVE: To evaluate the therapeutic efficacy of iguratimod in combination with conventional therapy in patients with rheumatoid arthritis (RA) and to explore changes in hematological and ultrasonographic parameters, as well as their correlations with disease activity. METHODS: This single-center, retrospective clinical study involved 79 RA patients, including 49 in the combination therapy group (iguratimod plus conventional therapy) and 30 in the standard therapy group (conventional therapy alone). The following parameters were assessed at baseline and after 12 weeks of treatment: the Disease Activity Score in 28 joints (DAS28), Visual Analogue Scale (VAS) scores, inflammatory markers (high-sensitivity C-reactive protein, hs-CRP; erythrocyte sedimentation rate, ESR; rheumatoid factor, RF), joint function grades, and ultrasonographic features-including synovial thickness, cartilage thickness, blood flow signals, joint effusion, and synovial arterial resistance index (RI). Adverse events were recorded to assess drug safety. RESULTS: After 12 weeks of treatment, the overall clinical efficacy rate was significantly higher in the combination therapy group than in the standard therapy group (95.92% vs. 76.67%, P<0.05). Patients in the combination therapy group showed significant decreases in DAS28, VAS scores, morning stiffness duration (all P<0.05). After 12 weeks of treatment, the levels of serum hs-CRP, ESR and RF levels in the combined therapy group decreased significantly and were lower than those in the standard therapy group (all P < 0.05). Ultrasonography revealed marked reductions in synovial thickness, joint effusion, and synovial blood flow signals in the combination therapy group after treatment, along with a reduction in RI (P<0.05). Moreover, the proportion of Grade I joint function increased, while Grade IV proportion decreased significantly in the combination therapy group (P<0.05). The incidence of adverse events was comparable between groups, and no serious events occurred (P>0.05). CONCLUSION: Iguratimod combined with conventional therapy effectively alleviates inflammation, improves joint function, and mitigates structural damage in RA patients, with a favorable safety profile. Dynamic monitoring of hematological and imaging parameters provides a more comprehensive assessment of disease activity, supporting the clinical utility of iguratimod-based combination therapy in RA management.