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Ample evidence shows that both monitoring disease activity and aiming at remission,1–4 as well as using combinations of disease modifying antirheumatic drugs (DMARDs), are effective treatment strategies in early rheumatoid arthritis (RA).5–8 Still, some authorities stress the former, but ignore the latter.9
In the FIN-RACo trial, 195 patients with early, active RA were randomised for a 2-year treatment with either a triple-combination of DMARDs and prednisolone (FIN-RACo) or DMARD monotherapy and discretionary prednisolone (SINGLE); both drug treatment strategies aimed at strict remission.6 Thus, in case of active disease, all inflamed joints had to be injected with glucocorticoids and predefined DMARD treatment adjustments made. After 2 years, remission was more common in the FIN-RACo than in the SINGLE group (37% vs 18%), and in a multivariate analysis only the treatment strategy proved to predict remissions at 2 years.6 Further, at 5 years, work disability (WD) was less common in the FIN-RACo than in the SINGLE group, especially regarding the patients who had reached remission at 6 months.10
In these subanalyses we wanted to study separately the roles of targeted treatment and combination DMARD …
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