Disease-modifying antirheumatic drugs (DMARDs) should be used early and aggressively at the first sign of rheumatoid arthritis (RA), researchers have suggested.
"Early therapy with combinations of conventional DMARDs has been shown to retard the radiologic progression of RA for a period of up to 5 years, but until now the effects of initial aggressive DMARD therapy on radiologic prognosis after that were unknown. We've shown that even after 11 years, early and aggressive therapy achieves excellent results for most patients," said Dr Vappu Rantalaiho, from Tampere University Hospital, Finland.
For this study, 97 patients were initially randomised to receive a combination of DMARDs and 98 received a single DMARD. Patients treated initially with the multiple DMARD strategy were found to have less radiographic damage in small joints, even in the long term, than those treated initially with DMARD monotherapy.
"Our results emphasize the importance of early remission for long term outcome. In the present study, the patients who were in strict remission at 1 year had significantly less radiologic progression throughout the follow-up than the patients who were not," said Rantalaiho.
The study was published in BioMed Central's open access journal Arthritis Research and Therapy.