Abstract:
:Since 1990 the Utrecht Rheumatoid Arthritis Cohort study group has performed several clinical trials on different treatment strategies in early rheumatoid arthritis (RA) patients. From 1990 till 1994, patients were randomly assigned to the pyramid strategy group or the early DMARD group. Patients in the early DMARD group were allocated to one of the three following treatment strategies: strategy I, starting with hydroxychloroquine (HCQ); strategy II, starting with intramuscular gold (iAU); or strategy III, starting with oral methotrexate (MTX). After one year, statistically significant advantages for the early DMARD group compared with the pyramid group were found for disability, pain, joint score, and ESR. The increase in radiological damage did not differ significantly between the two strategy groups. These first year results proved that early introduction of DMARDs is more beneficial than a delayed introduction. After 5 years, however, no prolongation of the clinical advantages in favor of the early DMARD group, as observed after one year, was found. It was found that patients assigned to the pyramid group received more intra-articular injections during the first two years; at the end of this period 75% of them used DMARDs, especially the more aggressive DMARDs. Based on the first year results, all patients were randomly assigned to one of the three treatment strategies in the early DMARD group between 1994 and 1998. Patients who started with MTX or iAU as the first DMARD demonstrated better results regarding clinical efficacy and radiological damage after 2 years. However, more patients who received iAU therapy had to discontinue their therapy compared with patients who took MTX. We therefore conclude that MTX is the DMARD of first choice and that treatment should be tailored to the individual patient.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Verstappen SM,Jacobs JW,Bijlsma JW,Utrecht Rheumatoid Arthritis Cohort Study Group.keywords:
subject
Has Abstractpub_date
2003-09-01 00:00:00pages
S165-8issue
5 Suppl 31eissn
0392-856Xissn
1593-098Xjournal_volume
21pub_type
临床试验,杂志文章,随机对照试验abstract::An analysis is presented of 20 patients with the human immunodeficiency virus (HIV) infection who were treated for skeletal infection in our hospital. Seventeen cases of septic arthritis and three of osteomyelitis were found. All patients were intravenous drug abusers, 75% were male and all were younger than 40 years ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
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doi:
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2019-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2019-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2014-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2015-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,多中心研究
doi:
更新日期:2012-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1994-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,meta分析
doi:
更新日期:2020-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 临床试验,杂志文章
doi:
更新日期:2007-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00