Ann Rheum Dis 1998;57:88-93 ( February )

Extended reports

Improved functional outcome in patients with early rheumatoid arthritis treated with intramuscular gold: results of a five year prospective study Robin Munro, Rosie Hampson, Anne McEntegart, E Anne Thomson, Rajan Madhok, Hilary Capell

Centre for Rheumatic Diseases, Royal Infirmary, Glasgow

Correspondence to: Dr R Munro, Centre for Rheumatic Diseases, Wards 14/15, Royal Infirmary, Glasgow G4 0SF.

Accepted for publication 13 January 1998

OBJECTIVETo determine whether there is a relation between disease duration and functional outcome in patients with rheumatoid arthritis (RA) treated with intramuscular sodium aurothiomolate (gold) for five years.
METHODS440 patients with RA were enrolled in a prospective trial of gold treatment. Initial demographic details were recorded. Disease activity was assessed at yearly intervals using a combination of clinical (pain score, Ritchie articular index, duration of morning stiffness) and laboratory (erythrocyte sedimentation rate, C reactive protein) parameters. Change in functional status was assessed using the health status questionnaire (HAQ). Patients were stratified according to disease duration at outset (group 1= 0-2 years n=106, group 2 = >2-5 years n=93, and group 3= >5 years n=235).
RESULTSThere were no significant differences between the groups at outset. A total of 160 patients completed five years of treatment (group 1 n=44 (42%), group 2 n=37 (40%), and group 3 n=79 (34%)). Patients in group 1 had a significantly lower HAQ from year 1 to year 5 with a mean improvement of 30% at the end of the study (p<0.001). Neither group 2 nor group 3 had a significant change in their HAQ at study end. There were significant improvements in all other variables (p<0.05) in each group apart from pain in group 2.
CONCLUSIONPatients with early RA have a larger reversible component to their HAQ. Only patients with disease duration of up to two years have a longlasting improvement in their functional ability after starting intramuscular gold treatment.

Keywords: gold; rheumatoid arthritis; function; HAQ

---

© 1998 by Annals of the Rheumatic Diseases
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ma, M. H. Y., Kingsley, G. H., Scott, D. L. (2009). A systematic comparison of combination DMARD therapy and tumour necrosis inhibitor therapy with methotrexate in patients with early rheumatoid arthritis. Rheumatology (Oxford) 0: kep331v1-kep331 [Abstract] [Full Text]  
• Su, L., Tom, B. D. M., Farewell, V. T. (2009). Bias in 2-part mixed models for longitudinal semicontinuous data. Biostatistics 10: 374-389 [Abstract] [Full Text]  
• Liao, K P, Batra, K L, Chibnik, L, Schur, P H, Costenbader, K H (2008). Anti-cyclic citrullinated peptide revised criteria for the classification of rheumatoid arthritis. Ann Rheum Dis 67: 1557-1561 [Abstract] [Full Text]  
• Mary Davies, L., Anne Fargher, E., Tricker, K., Dawes, P., Scott, D. L, Symmons, D. (2007). Is shared care with annual hospital review better value for money than predominantly hospital-based care in patients with established stable rheumatoid arthritis?. Ann Rheum Dis 66: 658-663 [Abstract] [Full Text]  
• Suresh, E, Lambert, C M (2005). Combination treatment strategies in early rheumatoid arthritis. Ann Rheum Dis 64: 1252-1256 [Abstract] [Full Text]  
• Plant, M. J., O'Sullivan, M. M., Lewis, P. A., Camilleri, J. P., Coles, E. C., Jessop, J. D. (2005). What factors influence functional ability in patients with rheumatoid arthritis. Do they alter over time?. Rheumatology (Oxford) 44: 1181-1185 [Abstract] [Full Text]  
• Nell, V. P. K., Machold, K. P., Eberl, G., Stamm, T. A., Uffmann, M., Smolen, J. S. (2004). Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford) 43: 906-914 [Abstract] [Full Text]  
• Dubucquoi, S, Solau-Gervais, E, Lefranc, D, Marguerie, L, Sibilia, J, Goetz, J, Dutoit, V, Fauchais, A-L, Hachulla, E, Flipo, R-M, Prin, L (2004). Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis 63: 415-419 [Abstract] [Full Text]  
• Brennan, A., Bansback, N., Reynolds, A., Conway, P. (2004). Modelling the cost-effectiveness of etanercept in adults with rheumatoid arthritis in the UK. Rheumatology (Oxford) 43: 62-72 [Abstract] [Full Text]  
• Scott, D. L., Strand, V. (2002). The effects of disease-modifying anti-rheumatic drugs on the Health Assessment Questionnaire score. Lessons from the leflunomide clinical trials database. Rheumatology (Oxford) 41: 899-909 [Abstract] [Full Text]  
• Kvien, T K, Zeidler, H K, Hannonen, P, Wollheim, F A, Forre, O, Hafstrom, I, Kaltwasser, J P, Leirisalo-Repo, M, Manger, B, Laasonen, L, Prestele, H, Kurki, P (2002). Long term efficacy and safety of cyclosporin versus parenteral gold in early rheumatoid arthritis: a three year study of radiographic progression, renal function, and arterial hypertension. Ann Rheum Dis 61: 511-516 [Abstract] [Full Text]  
• Emery, P, Breedveld, F C, Dougados, M, Kalden, J R, Schiff, M H, Smolen, J S (2002). Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis 61: 290-297 [Abstract] [Full Text]  
• Quinn, M. A., Conaghan, P. G., Emery, P. (2001). The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence?. Rheumatology (Oxford) 40: 1211-1220 [Abstract] [Full Text]  
• Madhok, R., Kerr, H., Capell, H. A (2000). Recent advances: Rheumatology. BMJ 321: 882-885 [Full Text]  
• Harrison, B., Symmons, D. (2000). Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature. II. Outcome at three years. Rheumatology (Oxford) 39: 939-949 [Full Text]  
• Uhlig, T., Smedstad, L M., Vaglum, P., Moum, T., Gerard, N., Kvien, T. K. (2000). The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up. Rheumatology (Oxford) 39: 732-741 [Abstract] [Full Text]  
• Scott, D. L., Pugner, K., Kaarela, K., Doyle, D. V., Woolf, A., Holmes, J., Hieke, K. (2000). The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford) 39: 122-132 [Abstract] [Full Text]  
• Sokka, T., Mottonen, T., Hannonen, P. (2000). Disease-modifying anti-rheumatic drug use according to the `sawtooth' treatment strategy improves the functional outcome in rheumatoid arthritis: results of a long-term follow-up study with review of the literature. Rheumatology (Oxford) 39: 34-42 [Abstract] [Full Text]