Treatment strategy, disease activity, and outcome in four cohorts of patients with early rheumatoid arthritis.
OBJECTIVE
To compare four different inception cohorts of patients with early rheumatoid arthritis (RA) with respect to treatment strategies, disease activity, and outcome during a five year follow up period.


METHODS
Data from cohorts of patients with early RA, with a standardised assessment at least every six months for five years from four different centres, were included in one database. Owing to slight differences in the individual study designs, linearly interpolated values were calculated to complete the standard follow up schedule.


RESULTS
Despite similar inclusion criteria, significant differences in demographic factors and baseline disease activity were found between the different cohorts. During the follow up an aggressive treatment strategy was followed in the Dutch and Finnish cohort, an intermediate strategy in the British cohort, and a conservative strategy in the Swedish cohort. A significant improvement in disease activity was seen in all cohorts, though the most rapid and striking improvement was seen in those receiving aggressive treatment. This resulted in less radiographic destruction in the long run.


CONCLUSIONS
This observational study of cohorts of patients with early RA confirms that early aggressive treatment results not only in a more rapid reduction of disease activity but also in less radiographic progression in the long term.
Albers
J M
JM
Department of Rheumatology, Nijmegen University Hospital, The Netherlands.
Paimela
L
L
Kurki
P
P
Eberhardt
K B
KB
Emery
P
P
van 't Hof
M A
MA
Schreuder
F H
FH
Leirisalo-Repo
M
M
van Riel
P L
PL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011859:Radiography; D018709:Statistics, Nonparametric; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
D018501:Antirheumatic Agents