title: Rheumatoid nodules do not predict response to treatment with slow-acting anti-rheumatic drugs.
abstract: Rheumatoid nodules have been associated with a poor long-term prognosis. We investigated whether they predict a poor response to treatment with slow-acting anti-rheumatic drugs (SAARDs). Two hundred and twenty-eight patients with rheumatoid arthritis (RA) were treated for six months with a SAARD. Clinical and laboratory assessments of disease activity were made initially and after 6 months' treatment. Patients were divided into two groups according to the presence or absence of nodules at entry. Twenty-one % had nodules before treatment but their response was no different to patients without nodules (79%), both groups showing improvements in all variables. Males were more likely to develop nodules and had a relative risk of 1.7. High titres of rheumatoid factor correlated with nodules and no sero-negative patients had nodules. We conclude that nodules are not predictive of poor response to treatment with a SAARD, despite their presence being associated with a poor long-term prognosis. One possible implication is that SAARDs themselves, despite an early response, may not effect long-term outcome.
authors.affiliation: Department of Rheumatology, St Bartholomew's and Homerton Hospital, London.
authors.forename: G M
authors.initials: GM
authors.lastname: Hall
authors.forename: A
authors.initials: A
authors.lastname: Studnicke
authors.forename: E C
authors.initials: EC
authors.lastname: Huskisson
authors.forename: D L
authors.initials: DL
authors.lastname: Scott
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D012218:Rheumatoid Nodule / Q000150:complications*; D012720:Severity of Illness Index; D012727:Sex Characteristics
chemical_list: D000893:Anti-Inflammatory Agents; D010396:Penicillamine