RESEARCH - RA Patients have better articular, radiographic, laboratory, and functional status in 2000 than in 1985

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Arthritis Rheum. 2005 Apr;52(4):1009-19.

Patients seen for standard rheumatoid arthritis care have significantly

better articular, radiographic, laboratory, and functional status in 2000

than in 1985.

Pincus T, Sokka T, Kautiainen H.

Vanderbilt University, Nashville, Tennessee.

OBJECTIVE: A comprehensive quantitative analysis of measures of disease

activity and joint damage has not been available to compare patients in

different eras in the same clinical setting. This study was undertaken to

determine whether the clinical status of patients with rheumatoid arthritis

(RA) has improved on average in recent years. METHODS: A quantitative

cross-sectional evaluation, which included joint count, radiographic,

laboratory, patient questionnaire, and physical function measures, and

therapies, was performed in 125 consecutive RA patients seen from 1984

through 1986 ( " 1985 cohort " ). A virtually identical assessment was performed

in 150 patients seen from 1999 through 2001 ( " 2000 cohort " ), in the same

weekly academic clinic. Measures were compared using descriptive statistics

and a median regression model, adjusted for age, duration of disease, level

of formal education, and rheumatoid factor. RESULTS: Patients in 1985 had

significantly poorer status compared with those in 2000: median 12 versus 5

swollen joints, Larsen radiographic score 20 versus 3, erythrocyte

sedimentation rate 33 mm/hour versus 20, and modified Health Assessment

Questionnaire 1.0 versus 0.4 (P < 0.019). Severe Disease Activity Scores

>5.1 were seen in 69% of 1985 patients, compared with 30% in 2000.

Methotrexate was taken by 10% of patients in 1985, versus 76% in 2000. The

proportion of patients not taking any disease-modifying antirheumatic drugs

was 66% in 1985 versus 13% in 2000.

CONCLUSION: Patients receiving standard care for RA in this setting had

significantly better status, including radiographic scores, in 2000 than in

1985, associated with aggressive treatment strategies, prior to the

introduction of biologic agents.

PMID: 15818706

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5818706 & dopt=Abstract

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