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Logo of annrheumdAnnals of the Rheumatic DiseasesCurrent TOCInstructions for authors
Ann Rheum Dis. May 2001; 60(5): 453–458.
PMCID: PMC1753652
Treatment strategy, disease activity, and outcome in four cohorts of patients with early rheumatoid arthritis
J Albers, L Paimela, P Kurki, K Eberhardt, P Emery, Hof M A van `t, F Schreuder, M Leirisalo-Repo, and P L C M van Riel
Department of Rheumatology, Nijmegen University Hospital, The Netherlands.
OBJECTIVE—To compare four different inception cohorts of patients with early rheumatoid arthritis (RA) with respect to treatment strategies, disease activity, and outcome during a five year follow up period.
METHOD—Data from cohorts of patients with early RA, with a standardised assessment at least every six months for five years from four different centres, were included in one database. Owing to slight differences in the individual study designs, linearly interpolated values were calculated to complete the standard follow up schedule.
RESULTS—Despite similar inclusion criteria, significant differences in demographic factors and baseline disease activity were found between the different cohorts. During the follow up an aggressive treatment strategy was followed in the Dutch and Finnish cohort, an intermediate strategy in the British cohort, and a conservative strategy in the Swedish cohort. A significant improvement in disease activity was seen in all cohorts, though the most rapid and striking improvement was seen in those receiving aggressive treatment. This resulted in less radiographic destruction in the long run.
CONCLUSION—This observational study of cohorts of patients with early RA confirms that early aggressive treatment results not only in a more rapid reduction of disease activity but also in less radiographic progression in the long term.

Figure 1
Figure 1  
The course of the disease during the five year follow up period (median values and 95% confidence intervals). ESR = erythrocyte sedimentation rate; VAS = visual analogue scale; RAI = Ritchie Articular Index; (more ...)
Figure 2
Figure 2  
Median radiographic (Larsen) scores (95% confidence intervals).
Figure 3
Figure 3  
Dutch median radiographic (Sharp) scores (95% confidence intervals).
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