A retrospective analysis of rheumatoid arthritis patients with disease duration of 2 years or less who had received aggressive treatment using oral disease-modifying antirheumatic drugs according to their disease activities

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  • 発症２年以内の関節リウマチに対して，経口抗リウマチ薬を病勢に応じて積極的に使用した症例のレトロスペクティブ解析

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Abstract

    Purpose: To verify the usefulness of aggressive treatment of early-onset rheumatoid arthritis with combination therapy of oral disease-modifying antirheumatic drugs (DMARDs). Patients and treatment: We retrospectively analyzed up 5-year therapeutic process in 27 rheumatoid arthritis (RA) patients with disease duration of 2 years or less, who consented to aggressive treatment with oral DMARDs in order to achieve remission. These patients were selected from among those who visited Tokorozawa Central Hospital between July 1997 and January 2006. When the treatment was started, tender joint count, swollen joint count, and C-reactive protein level were monitored weekly or biweekly. After the disease activity of RA fully decreased, these parameters were monitored monthly or bimonthly. If any of these indicators did not improve, the dose of the DMARD(s) was increased and/or additional DMARDs were prescribed. Results: Follow-up showed that 19 (70%) of the 27 patients achieved clinical remission within1year.The remission status remained almost unchanged during 5 years of follow-up, and in the 5th year of observation, 21 (84%) of the 25 patients who were followed up showed clinical remission. The health assessment questionnaire (HAQ) score for the 5th year was evaluated in 23 patients (median HAQ score, 0.125), and 65% of them achieved functional remission with HAQ scores of less than 0.5, the levels at which the patients’ quality of life was relatively high. Conclusion: The usefulness of aggressive treatment with oral DMARDs was confirmed.

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