[Favorable results of early 2nd-stage medication in rheumatoid arthritis].

OBJECTIVE

To compare the effects of treatment with and without 'slow-acting antirheumatic drugs' (SAARDs) for patients with recent-onset rheumatoid arthritis (RA).

DESIGN

Open randomized clinical trial.

SETTING

Outpatient clinics of six medical centers, the Netherlands.

METHOD

The study population consisted of 304 consecutive patients with recently diagnosed RA. A therapeutic strategy with delayed introduction of a SAARD was compared with a strategy comprising early start of SAARD treatment. Primary endpoints were functional disability, pain, joint score, erythrocyte sedimentation rate and progression of radiological abnormalities at 12 months.

RESULTS

Four of the five endpoints improved statistically significantly more in the early-SAARD group than in the non-SAARD group; radiological abnormalities progressed at an equal rate in the two groups. Adverse reactions remained at an acceptable level and were the same in the two groups.

CONCLUSION

Early introduction of a SAARD was more beneficial than a therapeutic strategy with delayed introduction of a SAARD for patients with recently diagnosed RA.