Tight control is a way of optimizing the treatment of patients with rheumatoid arthritis
https://doi.org/10.14412/1995-4484-2010-1418
Abstract
Objective: To evaluate the time course of changes in the symptoms of rheumatoid arthritis (RA) and its activity index during tight control in routine clinical practice.
Subjects and methods. One hundred and twelve Khabarovsk outpatients with the valid (by the American College of Rheumatology (ACR) criteria) diagnosis of RA (88 females and 24 males; their mean age 37,8±1,9 years) were followed up. The patients were divided into 2 groups: 1) those who had been followed up once every 3-4 months by a rheumatologist in real clinical practice for 2 years; 2) those who were tightly controlled (estimation of the number of swollen and tender joints and general conditions, pain scores by the visual analogue
58
НАУЧНО-ПРАКТИЧЕСКАЯ РЕВМАТОЛОГИЯ, 2010, № 2, 51-58
ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ
scale, erythrocyte sedimentation rate, by calculating the disease activity score (DAS) 28 and functional index by the Health Assessment Questionnaire (HAQ)) by an investigating rheumatologist once monthly. The significance of differences between the groups was estimated by Student's t-test (a significant difference at p<0,05).
Results. In Group 1, 32,8% of the patients achieved the permissible activity (< second-degree) of RA during 2 years. Remission was recorded in 8.6% of cases. The HAQ functional activity failed to achieve the goal level (1,8±0,4 and 1,7±0,8 following 12 and 24 months, respectively. In the tight control group 2 (n = 54), remission was observed in 47 (87%) patients: induced remission in 17 (31,5%) cases and remission during therapy in 30 (55,6%) patients. The decrease rates for all clinical parameters of RA were much higher in Group 2. Changes were noted by just month 3; a significant improvement was achieved by month 6 (p<0,05) and this difference was obvious by months 12 and 24 (p<0,01 and p<0,001).
Conclusion. Thus, tight control provides a greater opportunity to make timely and adequately correct treatment, by applying the DAS 28 and HAQ score, remission or decreased RA activity is achieved more rapidly.
Subjects and methods. One hundred and twelve Khabarovsk outpatients with the valid (by the American College of Rheumatology (ACR) criteria) diagnosis of RA (88 females and 24 males; their mean age 37,8±1,9 years) were followed up. The patients were divided into 2 groups: 1) those who had been followed up once every 3-4 months by a rheumatologist in real clinical practice for 2 years; 2) those who were tightly controlled (estimation of the number of swollen and tender joints and general conditions, pain scores by the visual analogue
58
НАУЧНО-ПРАКТИЧЕСКАЯ РЕВМАТОЛОГИЯ, 2010, № 2, 51-58
ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ
scale, erythrocyte sedimentation rate, by calculating the disease activity score (DAS) 28 and functional index by the Health Assessment Questionnaire (HAQ)) by an investigating rheumatologist once monthly. The significance of differences between the groups was estimated by Student's t-test (a significant difference at p<0,05).
Results. In Group 1, 32,8% of the patients achieved the permissible activity (< second-degree) of RA during 2 years. Remission was recorded in 8.6% of cases. The HAQ functional activity failed to achieve the goal level (1,8±0,4 and 1,7±0,8 following 12 and 24 months, respectively. In the tight control group 2 (n = 54), remission was observed in 47 (87%) patients: induced remission in 17 (31,5%) cases and remission during therapy in 30 (55,6%) patients. The decrease rates for all clinical parameters of RA were much higher in Group 2. Changes were noted by just month 3; a significant improvement was achieved by month 6 (p<0,05) and this difference was obvious by months 12 and 24 (p<0,01 and p<0,001).
Conclusion. Thus, tight control provides a greater opportunity to make timely and adequately correct treatment, by applying the DAS 28 and HAQ score, remission or decreased RA activity is achieved more rapidly.
References
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Review
For citations:
Otteva E.N. Tight control is a way of optimizing the treatment of patients with rheumatoid arthritis. Rheumatology Science and Practice. 2010;48(2):58-65. (In Russ.) https://doi.org/10.14412/1995-4484-2010-1418
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