Ann Rheum Dis 2001;60:453-458 ( May )

Extended report

Treatment strategy, disease activity, and outcome in four cohorts of patients with early rheumatoid arthritis J M C Albers^a, L Paimela^b, P Kurki^c, K B Eberhardt^d, P Emery^e, M A van `t Hof^a, F H J M Schreuder^a, M Leirisalo-Repo^f, P L C M van Riel^a

^a Department of Rheumatology, Nijmegen University Hospital, The Netherlands, ^b Department of Rheumatology, Helsinki City Hospital, Finland, ^c Department of Rheumatology, National Agency for Medicines, Helsinki, Finland, ^d Department of Rheumatology, Lund University Hospital, Sweden, ^e Department of Rheumatology, University of Leeds, United Kingdom, ^f Department of Rheumatology, Helsinki University Central Hospital, Finland

Correspondence to: Dr P L C M van Riel, University Medical Centre Nijmegen, Department of Rheumatology, Geert Grooteplein 8, 6525 GA Nijmegen, The Netherlands P.vanRiel{at}reuma.azn.nl

Accepted for publication 23 October 2000

OBJECTIVETo compare four different inception cohorts of patients with early rheumatoid arthritis (RA) with respect to treatment strategies, disease activity, and outcome during a five year follow up period.
METHODData from cohorts of patients with early RA, with a standardised assessment at least every six months for five years from four different centres, were included in one database. Owing to slight differences in the individual study designs, linearly interpolated values were calculated to complete the standard follow up schedule.
RESULTSDespite similar inclusion criteria, significant differences in demographic factors and baseline disease activity were found between the different cohorts. During the follow up an aggressive treatment strategy was followed in the Dutch and Finnish cohort, an intermediate strategy in the British cohort, and a conservative strategy in the Swedish cohort. A significant improvement in disease activity was seen in all cohorts, though the most rapid and striking improvement was seen in those receiving aggressive treatment. This resulted in less radiographic destruction in the long run.
CONCLUSIONThis observational study of cohorts of patients with early RA confirms that early aggressive treatment results not only in a more rapid reduction of disease activity but also in less radiographic progression in the long term.

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© 2001 by Annals of the Rheumatic Diseases
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