Attitudes to early rheumatoid arthritis: changing patterns. Results of a survey. Issue 10 (10th September 2004)

• Record Type: Journal Article
• Authors: Aletaha, D; Eberl, G; Nell, V P K; Machold, K P; Smolen, J S
• Is Part Of: Annals of the rheumatic diseases. Volume 63:Issue 10(2004)
• Page Start: 1269
• Page End: 1275
• Publication Date: 2004-09-10
• Subjects: ACR, American College of Rheumatology -- CCP, cyclic citrullinated peptide -- DMARDs, disease modifying antirheumatic drugs -- MTX, methotrexate -- NSAID, non-steroidal anti-inflammatory drug -- RA, rheumatoid arthritis -- RF, rheumatoid factor; early arthritis -- diagnosis -- treatment; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2003.015131
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To determine if rheumatologists have changed their views on diagnosis and treatment of early rheumatoid arthritis (RA). Methods: Three consecutive questionnaires were sent out to international rheumatologists in 1997, 2000, and 2003. The following aspects of early RA were covered: definition; patient referral time; diagnostic means; follow up intervals; and treatment strategies. All initial participants who responded to at least one of the follow up surveys were included in the analysis. Results: RA is now defined by a smaller number of affected joints (monarthritis: 9.8% respondents in 1997 v 17.4% in 2003), and shorter symptom duration (<3 months: 65.5% in 1997 v 85.8% in 2003). Early referrals (<6 weeks) increased (8.9% in 1997 v 17.4% in 2003). Serological test for diagnosis was mostly rheumatoid factor (100% in 2003), but anti-CCP was already used by 17.4% in 2003. Follow up of patients with early RA intensified (every 2 weeks: 16.1% in 1997 v 30.4% in 2003; every month: 47.8% in 2003 v 64.3% in 1997). Treatment with disease modifying antirheumatic drugs (DMARDs) mainly comprised methotrexate, sulfasalazine, and antimalarial drugs. Leflunomide was among the two favourite DMARDs of 10.9% in 2003, whereas no biological agent was so. In 2003, 46.7% respondents started treatment with DMARDs if RA was suspected (30.9% in 1997); no one waited for erosions to occur (7.3% in 1997). Conclusion: The data obtained in this study suggest that the concept of diagnosing and treating RA early is accepted by a large proportion of the rheumatological community.