The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis.

Abstract:

:We assessed the anti-rheumatic effects of radical multiple synovectomy (RaMS) in patients with rheumatoid arthritis (RA) who did not respond to intensive medical treatment. The selection of patients into three groups, A, B or C, was randomised. Patients assigned to group A (n = 28) continued the prescribed pre-operative medication and had RaMS. Patients assigned to group B (n = 20) were started on a combination therapy with disease-modifying anti-rheumatic drugs (DMARDs) after radical multiple synovectomy. Nineteen RA patients who were started on the same combination therapy as group B but who did not undergo surgery served as controls (group C). The clinical and radiographic findings were assessed for at least 3 years after surgery. Patients in the surgically treated groups (groups A and B) showed a significant reduction in the number of swollen and painful joints and in their ESR and serum CRP levels, and this effect was maintained for at least 3 years. More than 40% of the patients remained in clinical remission during the observation period. The surgical outcome seemed to be superior to that of the controls and did not differ between group A and group B. Articular destruction (assessed by the carpal height ratio) did not progress in the patients who were in clinical remission.

journal_name

Int Orthop

authors

Nakamura H,Nagashima M,Ishigami S,Wauke K,Yoshino S

doi

10.1007/s002640000168

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

242-5

issue

5

eissn

0341-2695

issn

1432-5195

journal_volume

24

pub_type

临床试验,杂志文章,随机对照试验
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