Functional outcomes of rheumatoid arthritis during various proceduresof anti-inflammatory therapy
https://doi.org/10.14412/1995-4484-2010-1413
Abstract
Objective. To study the functional outcomes of rheumatoid arthritis (RA) 1, 3, 5, and 8 years after use of various procedures of anti-inflammatory therapy.
Subjects and methods. One hundred patients with valid RA were examined. The patients were divided into 3 groups: 1) 38 patients received basic anti-inflammatory drugs (BAIDs) only; 2) 37 patients took BAIDs in combination with glucocorticoids (GCs); 3) 25 patients had synchronous programmed intensive therapy.
Results. The early use of therapy with BAIDs without GCs in controlled therapy allows functional outcome improvement in patients in RA to greater extent. No therapy control leads to functional outcome worsening in RA. During a long follow-up, there is a reduction in the correlation of the Health Assessment Questionnaire (HAQ) scores with the parameters reflecting disease activity and an increase in the correlation of the HAQ with those reflecting the progression of RA. The development of the structural and anatomic changes in hand periarticular tissues with the formation of irreversible deformities does not correlate with the HAQ score in patients with RA.
Subjects and methods. One hundred patients with valid RA were examined. The patients were divided into 3 groups: 1) 38 patients received basic anti-inflammatory drugs (BAIDs) only; 2) 37 patients took BAIDs in combination with glucocorticoids (GCs); 3) 25 patients had synchronous programmed intensive therapy.
Results. The early use of therapy with BAIDs without GCs in controlled therapy allows functional outcome improvement in patients in RA to greater extent. No therapy control leads to functional outcome worsening in RA. During a long follow-up, there is a reduction in the correlation of the Health Assessment Questionnaire (HAQ) scores with the parameters reflecting disease activity and an increase in the correlation of the HAQ with those reflecting the progression of RA. The development of the structural and anatomic changes in hand periarticular tissues with the formation of irreversible deformities does not correlate with the HAQ score in patients with RA.
About the Authors
Natalya Vladimirovna ChichasovaS A Vladimirov
G R Imametdinova
E V Igolkina
E L Nasonov
References
1. <div><p>Harris E.D. Rheumatoid arthritis. Pathophysiology and implications for therapy. N Engl J Med 1990;322:1277-89.</p><p>Combe B., Landewe R., Lukas C. et al. EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2007;66:34-45.</p><p>Kanevskaya M.Z., Chichasova N.V. Treatment of early rheumatoid arthritis: influence on parameters of activity and progression in long-term prospective study. Ann Rheum Dis 2003;672(Suppl. 1):179 (Annual European Congress of Rheumatology, EULAR 2003, Abstracts).</p><p>Van Gestel A.M., Laan R.F.J.M., Haagsma C.J. et al. Oral steroids as bridge therapy in rheumatoid arthritis patients starting with parenteral gold. A randomised double-blind placebo-controlled trial. Br J Rheumatol 1995;34:347-51.</p><p>Kirwan J.R. The effect of glucocorticoids on joint destruction in rheumatoid arthritis. The Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group. N Engl J Med 1995;333:142-6.</p><p>Goecor-Ruiterman Y.P., de Vries-Bouwstra J.K., Allaart C.F. et al. Clinical and radiographc outcomes of four different treatment strategies in pations with early rheumatoid arthritis (the BeST study): a randomised, controlled trial. Arthr Rheum 2005;52:3381-90.</p><p>Wassenberg S., Rau R., Steinfeld P., Zeidler H. Very low-dose prednisolone in early rheumatoid arthritis retards radiographic progression over two years: a multicenter, double-blind, placebo-controlled trial. Arthr Rheum 2005;52:3371-80.</p><p>Svensson B., Boonen A., Albertsson K. et al. Low-dose prednisolone in addition to the initial disease-modifying antirheumatic drug in patient with early active rheumatoid arthritis reduces joint destruction and increases the remission rate: a 2-year randomized trial. Arthr Rheum 2005;52:3360-70.</p><p>Prevoo M.L.L., van Hoff M.A., Kuper H.H. et al. Modified disease activity scores that include twenty-eight-joints counts. Arthr Rheum 1995;38:44-52.</p><p>Крель А.А., Каневская М.З., Болотин Е.В., Чичасова Н.В. Объективизация проявлений ревматоидного артрита, характеризующих его активность и прогрессирование. I. Метод количественной оценки выраженности эрозивного артрита и темпов его прогрессирования в суставах кистей и стоп. Вопр pевм 1981;3:11-5.</p><p>Pincus T., Swearingen C., Wolfe F. Toward a multy-dimensional Health Assessment Questionnaire (MDHAQ) - assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthr Rheum 1999;42:2220-30.</p><p>Болотин Е.В., Крель А.А., Александрова Е.Г. и др. Объективизация проявлений ревматоидного артрита, характеризующих его эволюцию. IV. Методы оценки струк турно-анатомических повреждений параартикулярных тканей кисти и функциональной способности больных. Вопр pевм 1982;4:23-7.</p><p>Grigor C., Capell H., Stirling A. et al. Effect of treatment strategy of tight control of rheumatoid arthritis (the TIСORA study): a single-blind randomised controlled trial. Lancet 2004;364:263-9.</p><p>Bijlsma J.W., Weinblatt M.E. Optimal use of the methotrexate: the advantages of tight control. Ann Rheum Dis 2007;66:1409-10.</p><p>Verstappen S.M.M., Jacobs J.W., van der Veen M.J. et al. Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial). Ann Rheum Dis 2007;66:1443-9.</p><p>Felson D.T., Anderson J.J., Boers M. et al. American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. Arthr Rheum 1995;38:727-35.</p><p>Имаметдинова Г.Р. Оценка эффектив ности и переносимости метотрексата и его комбинаций с плаквенилом и циклоспорином А (сандиммун) у больных ревматоидным артритом: Автореф. дис. … канд. мед. наук, 1998;24 с.</p><p>Pincus T., Callachan L.F. What is the natural history of rheumatoid arthritis? Rheum Dis Clin North Am 1993;19:123-51.</p><p>Fex E., Larsen B.M., Nived K., Eberhardt K. Effect of rheumatoid arthritis on work status and leisure time activities in patients followed 8 years from onset J Rheumatol 1998;25(1):44-50.</p><p>Фоломеева О.М., Лобарева Л.С., Ушакова М.А. Инвалидность, обусловленная ревматическими заболеваниями, среди жителей Российской Федерации. Науч.-практич ревматол 2001;1:15-21.</p><p>Joint Committee of the Medical Research Council and the Nuffield Foundation. A comparison of prednisolone and aspirin in the treatment of rheumatoid arthritis. Ann Rheum Dis 1960;19:331-7.</p><p>Hooyman J.R., Melton L.J., Nelson A.M. et al. Fractures after rheumatoid arthritis. A population-based study. Arthr Rheum 1984;27:1358-61.</p><p>Cooper C., Coupland C., Mitchell M. Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 1995;54:49-52.</p></div><br />
Review
For citations:
Chichasova N.V., Vladimirov S.A., Imametdinova G.R., Igolkina E.V., Nasonov E.L. Functional outcomes of rheumatoid arthritis during various proceduresof anti-inflammatory therapy. Rheumatology Science and Practice. 2010;48(2):30-36. (In Russ.) https://doi.org/10.14412/1995-4484-2010-1413
Views:
1145
Email this article 