Disease modifying anti-rheumatic drugs in people with cystic fibrosis-related arthritis

The use of drugs to slow or stop progression of arthritis related to CF.

Arthritis is not a common complication of cystic fibrosis but it can cause major problems when it does occur. There are two distinct types of arthritis in cystic fibrosis: cystic fibrosis-related arthropathy and hypertrophic pulmonary osteoarthropathy. The best treatment for these conditions is not clear because of the underlying disease and its intense treatment. Anti-inflammatory and analgesic drugs treat the symptoms of arthritis but only disease modifying anti-rheumatic drugs (DMARDs) can stop or slow progression of the disease. We planned to report evidence from clinical trials to evaluate the effectiveness of different DMARDs compared with placebo, with each other or with no treatment. However, we were disappointed that we could not find any completed randomised controlled trials of these treatments or any evidence from non-randomised controlled trials. We suggest that there should be a randomised controlled trial to look at the effects and the safety of using DMARDs to slow or stop the progression of arthritis.