Background Rheumatoid arthritis (RA) is a chronical autoimmune disease that commonly presented with symmetrical polyarthritis of hands and feet. Pharmacological treatment options are non-steroid anti-inflammatory drugs (NSAIDs), glucocorticoids (GK) and disease modifying anti rheumatoid drugs (DMARDs) ([csDMARDs] or [tsDMARDs or [bDMARD].
Objectives In this study we aimed to review the use of NSAID and GK in our patients.
Methods The patients who diagnosed as RA at our office were included in the study. Patients were classified with EULAR 2010 RA criteria. The demographics and medications of the patients were recorded. All patients we examined pain with visual analog scale (VAS), global assessment of patient and doctor, number of tender and swollen joints (28 joints), health assessment questionnaire (HAQ), C – reactive protein (CRP), eritrocyte sedimentation rate (ESR), rheumatoid factor (RF) and anti – CCP. We assessed activity of disease by using disease activity score DAS28.
Results A total of 686 patients were enrolled in the study (580 female [84.5%], 106 male [15.5%]). Mean age was 53.23±12.21 and mean length of diagnosis was 10.74±7.59 months. The rate of extra-articular disease was 17.9% and the deformity rate was 31.3%. In all patients, activity of disease was mild in 55%, moderate in 37.8% and severe in 7.3% with regard to DAS28 score. The disease activity was mild in 54.6%, moderate in 43.11% and severe in 2.3% in patients who were using only NSAIDS. These rates of diseases activity was 57.2%, 40.7% and 2.1% in mild, moderate and severe disease respectively for the patients using only GK. In patients using both NSAIDs and GK, the disease activity was mild in 55%, moderate in 44% and severe in 1%. Comparison of the disease activity with medications revealed statistically significant difference in patients that using only NSAID and using both, but not in that using only steroid (respectively p: 0.022, p: 0.025, p: 0.46).
Conclusions In our study we found that patients has mild activity of disease use highly rates of NSAID and GC. It is important for providing remission using NSAIDs and GC along with DMARD. Our results demonstrate use of both GK and NSAIDS results in better outcomes.
Singh JA, Saag KG, Bridges SL Jr et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016 Jan;68(1):1–26.
Gaujoux-Viala C, Gossec L. When and for how long should glucocorticoids be used in rheumatoid arthritis? International guidelines and recommendations. Ann N Y Acad Sci. 2014 May; 1318:32–40.
Disclosure of Interest None declared