title: Failure in longterm treatment is rare in actively treated patients with rheumatoid arthritis, but may be predicted by high health assessment score at baseline and by residual disease activity at 3 and 6 months: the 5-year followup results of the randomized clinical NEO-RACo trial.
abstract: OBJECTIVE
  With modern initial aggressive combination treatments with synthetic disease-modifying antirheumatic drugs (sDMARD), most patients with rheumatoid arthritis (RA) achieve remission, have marginal radiographic progression, and sustain normal function. Here we aim to identify the patients failing these targets even after aggressive treatment.
  
  
  METHODS
  Ninety-nine patients with early, active RA were treated with a combination of 3 sDMARD and prednisolone (PRD), and either infliximab or placebo infusions during the first 6 months, aiming at strict remission. After 24 months, the treatments became unrestricted. At 60 months, 4 evident clinical features of treatment failure were defined: area under curve (AUC) between 6-60 months for disease activity score assessing 28 joints > 2.6; AUC 6-60 for health assessment questionnaire > 0.5; progression in total Sharp/van der Heijde score 0-60 months > 3 units; and need of PRD or biologic DMARD treatment at 60 months.
  
  
  RESULTS
  A total of 93 patients were followed up for 60 months. Of them, 45 had no features of treatment failure, 30 had 1, 10 had 2, 7 had 3, and 1 patient had all 4 features. Having 2-4 features of treatment failure at 5 years was predicted by the health assessment score at baseline, and by even low residual disease activity at 3 and 6 months.
  
  
  CONCLUSIONS
  Only 20% of the patients with RA treated early with combination sDMARD and PRD have more than 1 clinical feature of treatment failure at 60 months. Residual clinical disease activity at 3-6 months was the most important predictor for identifying these patients. The study was registered at www.clintrials.gov (NCT00908089).
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Vappu
authors.initials: V
authors.lastname: Rantalaiho
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Salme
authors.initials: S
authors.lastname: Järvenpää
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Markku
authors.initials: M
authors.lastname: Korpela
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Timo
authors.initials: T
authors.lastname: Malmi
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Pekka
authors.initials: P
authors.lastname: Hannonen
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Oili
authors.initials: O
authors.lastname: Kaipiainen-Seppänen
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Timo
authors.initials: T
authors.lastname: Yli-Kerttula
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Timo
authors.initials: T
authors.lastname: Möttönen
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Anu
authors.initials: A
authors.lastname: Mustila
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Anna
authors.initials: A
authors.lastname: Karjalainen
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Leena
authors.initials: L
authors.lastname: Paimela
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Toini
authors.initials: T
authors.lastname: Uutela
authors.affiliation: From the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; Fimlab Laboratories, Tampere; Unit of Primary Health Care; Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital; Department of General Practice; Institute of Clinical Medicine, University of Helsinki; Orton Hospital, Helsinki; Unit of Primary Health Care; Department of Medicine, Kuopio University Hospital, Kuopio; Medcare Foundation, Äänekoski; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki; Department of Medicine, Jyväskylä Central Hospital, Jyväskylä; Department of Rheumatology, Satakunta Central Hospital, Rauma; Division of Medicine and Department of Rheumatology, Turku University Hospital, Turku; Department of Medicine, Oulu University Hospital, Oulu; Central Hospital of Lapland, Rovaniemi, Finland.V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; H. Kautiainen, Professor of Biostatistics, Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Unit of Primary Health Care, Kuopio University Hospital; S. Järvenpää, Biostatistician, Medcare Foundation; M. Korpela, MD, PhD, Docent, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; T. Malmi, MD, Specialist in Rheumatology, Department of Medicine, Seinäjoki Central Hospital; P. Hannonen, MD, PhD, Professor, Head of Department, Department of Medicine, Jyväskylä Central Hospital; O. Kaipiainen-Seppänen, MD, PhD, Docent, Chief of Division, Department of Medicine, Kuopio University Hospital; T. Yli-Kerttula, MD, PhD, Chief of Division, Department of Rheumatology, Satakunta Central Hospital; T. Möttönen, MD, PhD, Professor, Chief of Division, Division of Medicine, Department of Rheumatology, Turku University Hospital; A. Mu
authors.forename: Marjatta
authors.initials: M
authors.lastname: Leirisalo-Repo
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001175:Arthrography; D001688:Biological Products / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011239:Prednisolone / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D011239:Prednisolone
keywords: DISEASE-MODIFYING ANTIRHEUMATIC DRUGS; OUTCOMES; PROGNOSIS; RHEUMATOID ARTHRITIS