THURSDAY, Sept. 8 (HealthDay News) -- Patients who present with early rheumatoid arthritis (RA) experience a milder disease course than those who were diagnosed with the illness 15 or 20 years ago, according to a study published in the September issue of Arthritis & Rheumatism.
Paco M.J. Welsing and colleagues at the Radboud University Nijmegen Medical Centre, in the Netherlands, conducted a retrospective analysis of records from 525 patients treated between 1985-2005. Aggressive RA therapy was more common in later years, indicated by a shorter lag time before initiation of disease-modifying antirheumatic drugs (DMARD) and/or prednisone, by longer duration of therapy use, by change in type of DMARD used, and by more frequent use of combination therapy and corticosteroids.
The Disease Activity Score in 28 joints (DAS28) at baseline and in the first five years after diagnosis was lower in 1995-2000 than in 1985-1990, and 1990-1995. In addition, the course of disease activity relative to disease duration was more favorable in recent years. In more recent patients, the researchers found that more aggressive RA therapy was associated with a milder disease course. However, the Health Assessment Questionnaire disability index actually increased in recent years.
"This contradictory result may be partly a distinction between measures of physical examination, laboratory results, and patient-assessed outcomes, which can be influenced by internal standards or attitudes of patients," the authors conclude.
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