PT  - JOURNAL ARTICLE
AU  - D Aletaha
AU  - G Eberl
AU  - V P K Nell
AU  - K P Machold
AU  - J S Smolen
TI  - Attitudes to early rheumatoid arthritis: changing patterns. Results of a survey
AID  - 10.1136/ard.2003.015131
DP  - 2004 Oct 01
TA  - Annals of the Rheumatic Diseases
PG  - 1269--1275
VI  - 63
IP  - 10
4099  - http://ard.bmj.com/content/63/10/1269.short
4100  - http://ard.bmj.com/content/63/10/1269.full
SO  - Ann Rheum Dis2004 Oct 01; 63
AB  - Objective: To determine if rheumatologists have changed their views on diagnosis and treatment of early rheumatoid arthritis (RA).Methods: Three consecutive questionnaires were sent out to international rheumatologists in 1997, 2000, and 2003. The following aspects of early RA were covered: definition; patient referral time; diagnostic means; follow up intervals; and treatment strategies. All initial participants who responded to at least one of the follow up surveys were included in the analysis.Results: RA is now defined by a smaller number of affected joints (monarthritis: 9.8% respondents in 1997 v 17.4% in 2003), and shorter symptom duration (<3 months: 65.5% in 1997 v 85.8% in 2003). Early referrals (<6 weeks) increased (8.9% in 1997 v 17.4% in 2003). Serological test for diagnosis was mostly rheumatoid factor (100% in 2003), but anti-CCP was already used by 17.4% in 2003. Follow up of patients with early RA intensified (every 2 weeks: 16.1% in 1997 v 30.4% in 2003; every month: 47.8% in 2003 v 64.3% in 1997). Treatment with disease modifying antirheumatic drugs (DMARDs) mainly comprised methotrexate, sulfasalazine, and antimalarial drugs. Leflunomide was among the two favourite DMARDs of 10.9% in 2003, whereas no biological agent was so. In 2003, 46.7% respondents started treatment with DMARDs if RA was suspected (30.9% in 1997); no one waited for erosions to occur (7.3% in 1997).Conclusion: The data obtained in this study suggest that the concept of diagnosing and treating RA early is accepted by a large proportion of the rheumatological community.