Rheumatoid arthritis (RA) is the most common inflammatory form of arthritis. It is a systemic, chronic, autoimmune disease for which there is no current cure. However, it is clear that early diagnosis and aggressive treatment can make a tremendous impact on prognosis and prevention of disability. In fact, the aim for every patient should be to get them into remission as soon as possible. Many clinicians have adopted the approach of starting early aggressive therapy in the hopes of inducing remission rapidly. This methodology was validated by a recent study.

In early inflammatory arthritis, higher rates of remission are achieved if treatment is started early with conventional therapies and patients are more closely followed, according to research presented recently at the American College of Rheumatology Annual Scientific meeting in Boston (November 6-12, 2007).

A prospective observational cohort of 103 patients with early inflammatory arthritis were evaluated to determine how many patients reached remission 12 months after the start of DMARD (disease-modifying anti-rheumatic drug) therapy. Investigators also compared the different methods of measuring remission currently in use by clinicians.

The average age of the patients was 46 years, and 80% were women. All had symptoms of early arthritis for more than six weeks but for less than 12 months, and all had two or more swollen joints or one swollen joint in the hand plus one additional symptom of arthritis (e.g., morning stiffness).

Fifty-nine percent of patients in the group began combination DMARD therapy (methotrexate plus another DMARD such as sulfasalazine or hydroxychloroquine); 40 percent started only methotrexate. At six and 12 months, 13 percent and 28 percent of the patients had started biologic therapy, respectively. By 12 months, only 20% of patients required biologic therapies.