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Patients with rheumatoid arthritis (RA) who start a new disease modifying anti-rheumatic drug (DMARD) are likely to show an improved response, researchers report in the October issue of the Journal of Rheumatology.
As lead investigator Dr. Veena Ranganath told Reuters Health, "We found that function improved more in patients with shorter disease duration and if patients had another DMARD added to their regimen. In addition, we demonstrated that function improves more when rheumatologists change DMARDs frequently during the course of the patient's disease."
Dr. Ranganath of the University of California, Los Angeles, and colleagues studied data on 889 patients with active RA. All had started a new DMARD, had at least 1 follow-up visit within a year, and had a modified Health Assessment Questionnaire (mHAQ) score of 0.5 or more or a Disease Activity Score 28-joint count of at least 1.6.
The team found that baseline mHAQ score, frequency of DMARD change, and addition of a new DMARD during follow-up were predictors of mHAQ response.
Improvement in mHAQ was generally associated with greater baseline disease activity. The total number of DMARDs ever used was not associated with mHAQ scores in any analysis.
In another analysis involving 1594 patients from the same database who remained on stable therapy, mHAQ worsened over time. In contrast, in the study cohort, there was a small but significant improvement over time.
"In all," concluded Dr. Ranganath, "this study confirms the need for rheumatologists to change RA medications as frequently as needed to reduce RA disease activity."
J Rheumatol 2008;35:1966-1971.
Lynn492008-11-08 12:28:45Thank-you for your posts, Lynn. I always look forward to reading and researching them.
Waddie
You're welcome
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