OBJECTIVE: To determine whether there is a relation between disease duration and functional outcome in patients with rheumatoid arthritis (RA) treated withintramuscular sodium aurothiomolate (gold) for five years. METHODS:440 patients with RA were enrolled in a prospective trial of gold treatment. Initial demographic details were recorded. Disease activity was assessed at yearly intervals using a combination of clinical (pain score, Ritchie articular index, duration of morning stiffness) and laboratory (erythrocyte sedimentation rate, C reactive protein) parameters. Change in functional status was assessed using the health status questionnaire (HAQ). Patients were stratified according to disease duration at outset (group 1 = 0-2 years n = 106, group 2 = > 2-5 years n = 93, and group 3 = > 5 years n = 235). RESULTS: There were no significant differences between the groups at outset. A total of 160 patients completed five years of treatment (group 1 n = 44 (42%), group 2 n = 37 (40%), and group 3 n = 79 (34%)). Patients in group 1 had a significantly lower HAQ from year 1 to year 5 with a mean improvement of 30% at the end of the study (p < 0.001). Neither group 2 nor group 3 had a significant change in their HAQ at study end. There were significant improvements in all other variables (p < 0.05) in each group apart from pain in group 2. CONCLUSION:Patients with early RA have a larger reversible component to their HAQ. Only patients with disease duration of up to two years have a longlasting improvement in their functional ability after starting intramuscular gold treatment.
RCT Entities:
OBJECTIVE: To determine whether there is a relation between disease duration and functional outcome in patients with rheumatoid arthritis (RA) treated with intramuscular sodium aurothiomolate (gold) for five years. METHODS: 440 patients with RA were enrolled in a prospective trial of gold treatment. Initial demographic details were recorded. Disease activity was assessed at yearly intervals using a combination of clinical (pain score, Ritchie articular index, duration of morning stiffness) and laboratory (erythrocyte sedimentation rate, C reactive protein) parameters. Change in functional status was assessed using the health status questionnaire (HAQ). Patients were stratified according to disease duration at outset (group 1 = 0-2 years n = 106, group 2 = > 2-5 years n = 93, and group 3 = > 5 years n = 235). RESULTS: There were no significant differences between the groups at outset. A total of 160 patients completed five years of treatment (group 1 n = 44 (42%), group 2 n = 37 (40%), and group 3 n = 79 (34%)). Patients in group 1 had a significantly lower HAQ from year 1 to year 5 with a mean improvement of 30% at the end of the study (p < 0.001). Neither group 2 nor group 3 had a significant change in their HAQ at study end. There were significant improvements in all other variables (p < 0.05) in each group apart from pain in group 2. CONCLUSION:Patients with early RA have a larger reversible component to their HAQ. Only patients with disease duration of up to two years have a longlasting improvement in their functional ability after starting intramuscular gold treatment.
Authors: T K Kvien; H K Zeidler; P Hannonen; F A Wollheim; O Førre; I Hafström; J P Kaltwasser; M Leirisalo-Repo; B Manger; L Laasonen; H Prestele; P Kurki Journal: Ann Rheum Dis Date: 2002-06 Impact factor: 19.103
Authors: S Dubucquoi; E Solau-Gervais; D Lefranc; L Marguerie; J Sibilia; J Goetz; V Dutoit; A-L Fauchais; E Hachulla; R-M Flipo; L Prin Journal: Ann Rheum Dis Date: 2004-04 Impact factor: 19.103
Authors: Linda C Li; Paul Adam; Anne F Townsend; Dawn Stacey; Diane Lacaille; Susan Cox; Jessie McGowan; Peter Tugwell; Gerri Sinclair; Kendall Ho; Catherine L Backman Journal: BMC Med Inform Decis Mak Date: 2009-08-20 Impact factor: 2.796