With Arthritis, Procastination Prolongs Pain

Immediate treatment of rheumatoid arthritis can lead to remission

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) It's unlikely that any patient who suffers from painful rheumatoid arthritis won't seek treatment for it. However, new research indicates that getting treatment earlier results in improved remission of the disease.

A study published in Arthritis Care & Research found that patients who started treatment at or before five years of diagnosis had a significantly improved chance of remission compared to patients who started treatment at or after eleven years of diagnosis.

dailyRx Insight: Delaying treatment after being diagnosed with RA reduces your remission chances.

Dr. Daniel E. Furst and colleagues from The University of California in Los Angeles looked at close to 5,000 rheumatoid arthritis patients registered in the Consortium of Rheumatology Researchers of North America (CORONA) registry. They selected patients who had received a nonbiologic disease-modifying antirheumatic drug (nbDMARD) (1,646 patients) , patients who had received an anti-tumor necrosis factor (TNF) (3,179 patients), and had gone to at least one follow-up visit. Remission was determined by using the Clinical Disease Activity Index (CDAI), along with the 28-joint Disease Activity score (DAS28) for remission determination. Patients were checked at a follow up visit at one year, and sustained remission was considered achieved with two consecutive visits.

Patients who were treated with both nbDMARDS and anti-TNF initiators had a significant association between CDAI remission and if they started treatment within 5 years of diagnosis. Remission (determined by the DAS28) was also more likely for patients who started treatment within 5 years.

There are approximately 1.3 million rheumatoid arthritis sufferers in the United States, about 75 percent of whom are women.  Rheumatoid arthritis affects and damages the synovial joints (joints that have a capsule) in the body, most commonly in the hands, feet, and cervical spine. Inflammation can also affects other organs and systems in the body such as the skin, lungs (fibrosis), kidneys (amyloid protein deposits), and cardiovascular system (increased risk for heart attack and stroke, as well as fibrosis and pericarditis). A clinical diagnosis can be made on the basis of symptoms, physical exam, radiographs, x-rays and lab tests. There are many prescription medications used to treat rheumatoid arthritis such as hydroxychloroquine (Plaquenil®), chloroquine (Aralen®), leflunomide (Arava®), and methotrexate (Rheumatrex ®). Non-pharmacological treatment includes psychical therapy, orthoses, and nutritional therapy but do not stop progression of joint destruction. Analgesi (painkillers) and anti-inflammatory drugs, including steroids, are used to suppress the symptoms, while disease-modifying antirheumatic (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage. In recent times, the newer group of biologics, such as abatacept (Orencia®), adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®), and rituximab (Rituxan®) have increased treatment options.

It is important to note that several of the study authors disclosed financial relationships with pharmaceutical companies, including Abbott, Amgen, BMS, Centocor, Genentech, Lilly, and Roche; supporter of the CORRONA database.  

Reviewed by: 
Review Date: 
March 9, 2011
Last Updated:
March 13, 2011