Positive outcomes in rheumatoid arthritis linked to early diagnosis

WASHINGTON - A new study has found that positive outcomes in rheumatoid arthritis (RA) are closely linked to early diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs).

Researchers in the Netherlands found that patients who are assessed by rheumatologists soon after RA symptoms appear are more likely to experience less joint destruction and improved chances of DMARD-free disease remission.

The World Health Organization (WHO) estimates that RA affects up to 1 percent of the population worldwide and is associated with increased morbidity, mortality, and healthcare costs.

This chronic, systemic disease is characterized by inflammation in the lining of the joints, which can frequently lead to joint damage.

Current medical evidence suggests that early initiation of an optimal RA treatment strategy-within 12 weeks of symptom onset-can prevent joint damage, improve long-term function, and increase the likelihood of achieving disease remission.

Michael van der Linden and colleagues from the Leiden University Medical Center examined 1674 early arthritis patients from the Leiden Early Arthritis Clinic cohort.

Researchers studied the associations among total delay to physician assessment, achievement of DMARD-free-remission, and the rate of joint damage over a six-year follow-up period.

Results showed the median patient and total delay in evaluation of early arthritis patients were 2.4, 8.0, and 13.7 weeks, respectively.

“Early treatment intervention dramatically improves clinical outcomes in patients with RA,” said van der Linden.

In 69 percent of RA patients, an examination by a rheumatologist took place 12 or more weeks after symptoms began, which researchers suggest contributed to a joint destruction rate that was 1.3 times higher than patients assessed prior to 12 weeks.

A delay in treatment was also associated with greater risk (1.87 hazard ratio) of not achieving DMARD-free disease remission.

“Our results highlight the importance of reducing the delay in assessment by a rheumatologist and further studies could test whether accelerated treatment leads to improved disease outcomes in RA,” concluded van der Linden .

Details of this novel study are published in the December issue of Arthritis and Rheumatism, a journal of the American College of Rheumatology. (ANI)