title: Second-line drugs used in recent-onset rheumatoid arthritis in Brittany (France).
abstract: OBJECTIVE
  The management of recent-onset rheumatoid arthritis (RA) is not well standardized. We conducted a survey of drugs prescribed to RA patients in Brittany at presentation and during the first 1 to 3 years of follow-up.
  
  
  METHODS
  A cohort of 270 patients with recent-onset inflammatory joint disease was recruited between 1995 and 1997. The evaluation at presentation included a medical history, a thorough physical examination, and a standard battery of investigations. Follow-up at 6-month intervals was offered. At the last visit, between June and December 1999, a panel of five rheumatologists established that 98 patients had RA.
  
  
  RESULTS
  At presentation, hydroxychloroquine and injectable gold were the most widely used second-line drugs, and only two patients were offered a combination of second-line drugs. At the last visit, the most commonly used drugs were methotrexate, injectable gold, and hydroxychloroquine (23, 23, and 21 patients, respectively); only three patients were on more than one second-line drug and 38 (38/98, 39%) patients were on glucocorticoid therapy.
  
  
  CONCLUSIONS
  Rheumatologists in Brittany prefer monotherapy with hydroxychloroquine or injectable gold as the initial treatment. Later, they rely mainly on methotrexate, injectable gold, and hydroxychloroquine, often in combination with glucocorticoid therapy.
authors.affiliation: Rheumatology department of Brest, hĵpital de la Cavale-Blanche, France. Alain.Saraux@univ-brest.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Berthelot
authors.forename: Gérard
authors.initials: G
authors.lastname: Chalès
authors.forename: Henaff Catherine
authors.initials: HC
authors.lastname: Le
authors.forename: Jean
authors.initials: J
authors.lastname: Thorel
authors.forename: Sylvie
authors.initials: S
authors.lastname: Hoang
authors.forename: Antoine
authors.initials: A
authors.lastname: Martin
authors.forename: Jérĵme
authors.initials: J
authors.lastname: Allain
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nouy-Trolle
authors.forename: Valérie
authors.initials: V
authors.lastname: Devauchelle
authors.forename: Pierre
authors.initials: P
authors.lastname: Youinou
authors.forename: Goff Paul
authors.initials: GP
authors.lastname: Le
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D050607:Organogold Compounds; D012219:Rheumatology / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D050607:Organogold Compounds; D006886:Hydroxychloroquine; D008727:Methotrexate