Treat Rheumatoid Arthritis Early And Aggressively For Best Results

According to the results of an 11-year trial, researchers recommend administering disease-modifying antirheumatic drugs (DMARDs) early and aggressively at the first sign of rheumatoid arthritis.

Results of the trial were published in BioMed Central’s open access journal Arthritis Research & Therapy. Active treatment from the very beginning pays off according to the results.

Dr. Vappu Rantalaiho, from Tampere University Hospital, Finland, studied radiologic progression in 195 patients with RA alongside a team of researchers.

"Early therapy with combinations of conventional DMARDs has been shown to retard the radiologic progression of RA for a period of up to 5 years, but until now the effects of initial aggressive DMARD therapy on radiologic prognosis after that were unknown,” she said, in a press release. “We've shown that even after 11 years, early and aggressive therapy achieves excellent results for most patients.”

Rantalaiho’s study included 97 patients that were initially randomized to receive a combination of DMARDs and 98 patients that received a single DMARD. The researchers found that after two years, the treatment of RA was unrestricted for both groups. Those in the group that received a combination of DMARDs were found to have less radiographic damage in small joints than those treated initially with DMARD monotherapy.

"Probably the most important precondition to our excellent results in most patients was the active treatment policy aiming at remission at all time points. Our results emphasize the importance of early remission for long term outcome. In the present study, the patients who were in strict remission at 1 year had significantly less radiologic progression throughout the follow-up than the patients who were not," Rantalaiho said.

Researchers concluded that early combination DMARDs and tight disease control improve long-term radiologic outcome in patients with early rheumatoid arthritis.