Scott D L, Grindulis K A, Struthers G R, Coulton B L, Popert A J, Bacon P A
Ann Rheum Dis. 1984 Feb;43(1):8-17. doi: 10.1136/ard.43.1.8.
A prospective study over one year of patients who had active rheumatoid arthritis discovered 64 who had received treatment for an adequate time with second-line drugs. In these patients there was evidence of continuing joint destruction as shown by radiological progression. During the year there were highly significant correlations between improvements in clinical and laboratory measurements, but neither group of tests was related to the degree of radiological change. However, in the second 6 months of treatment there was evidence that radiological progression was reduced. In a second prospective study of 88 patients with rheumatoid arthritis given prolonged, intensive therapy with second-line drugs and followed up for 10 years two-thirds showed radiological progression. However, the number of joints damaged per year fell significantly during the study period. There was a divergence between deterioration in radiological features and improvements in the ESR and functional capacity, though patients with a persistently low ESR had less radiological progression. These studies provide evidence that treatment may be associated with a reduced rate of radiological progression but suggest that changes in radiological progression and clinical and laboratory measurements may result from different mechanisms.
一项针对患有活动性类风湿关节炎患者的为期一年的前瞻性研究发现，有64名患者接受二线药物治疗的时间足够长。在这些患者中，有放射学进展表明存在持续关节破坏的证据。在这一年中，临床和实验室测量指标的改善之间存在高度显著的相关性，但两组测试均与放射学变化程度无关。然而，在治疗的第二个6个月，有证据表明放射学进展有所减少。在第二项针对88名类风湿关节炎患者的前瞻性研究中，这些患者接受了长期、强化的二线药物治疗并随访10年，三分之二的患者出现了放射学进展。然而，在研究期间每年受损关节的数量显著下降。放射学特征的恶化与红细胞沉降率（ESR）和功能能力的改善之间存在差异，尽管ESR持续较低的患者放射学进展较少。这些研究提供了证据表明治疗可能与放射学进展速率降低有关，但表明放射学进展以及临床和实验室测量指标的变化可能源于不同机制。
