title: Tight control early rheumatoid arthritis clinic in Hong Kong: a pilot study.
abstract: OBJECTIVE
  To evaluate disease activity in early rheumatoid arthritis patients in daily practice 1 year after applying a tight control treatment strategy aimed at lowering disease activity (Disease Activity Score 28, ≤ 3.2).
  
  
  METHODS
  Single-arm open trial with historical controls.
  
  
  METHODS
  Regional hospital, Hong Kong.
  
  
  METHODS
  All new rheumatoid arthritis patients (onset < 2 years) attending the tight control clinic from October 2008 to October 2009 were recruited. All the patients were followed up every 3 to 6 weeks and clinically assessed using the Disease Activity Score 28. Disease-modifying agent treatment was stepped up according to a preset protocol ladder and patient tolerance. The treatment target was to achieve a Disease Activity Score 28 of 3.2 or below (low disease activity). These patients were compared to matched historical controls in the rheumatology clinic.
  
  
  RESULTS
  Twenty patients in the tight control early rheumatoid arthritis clinic were recruited. Their disease activities were brought into better control than historical control patients who were followed up every 12 weeks. At week 52, clinical variables showed greater improvements in the intensive care group; respective mean scores (based on the Disease Activity Score 28 system) were 2.7 versus 4.2 (P<0.001); respective mean Health Assessment Questionnaire scores were 0.2 versus 1.3 (P<0.001).
  
  
  CONCLUSIONS
  Outcomes of patients attending our locally adapted tight control clinic were consistent with previous reports in the literature. The clinic reduced rheumatoid arthritis activity faster and better. It entailed more frequent follow-up and monitoring, however. To address this strategy more objectively, a randomised trial with parallel controls is necessary.
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong. kittykwokyan@gmail.com
authors.forename: Kitty Y
authors.initials: KY
authors.lastname: Kwok
authors.forename: M H
authors.initials: MH
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011446:Prospective Studies; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D012460:Sulfasalazine; D008727:Methotrexate