Don't Delay Arthritis Treatment, Researchers Warn

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Wed Jun 12, 2:10 PM ET

By Woodman

LONDON (Reuters Health) - Even short delays in prescribing drugs to patients

with rheumatoid arthritis can result in significantly worse outcomes,

according to study findings presented on Wednesday.

Rheumatoid arthritis is a chronic disease marked by inflammation in the

joints that causes pain, swelling and loss of mobility. It arises from an

abnormal immune system attack on the body's own tissue.

Austrian researchers said that although most rheumatologists already

recommend early use of so-called disease-modifying antirheumatic drugs in

patients with this condition, there was little data comparing the outcome of

very early intervention with somewhat delayed intervention in patients with

early disease.

They said their study shows there is a definite " window of opportunity " for

successful treatment.

In the 3-year study, 20 patients with very early disease who had waited an

average of 3 months before being started on drugs were compared with a

matched group of 20 patients who had waited 20 months to start therapy.

After just 3 months of treatment, Dr V.P.K. Nell and colleagues at the

University Hospital of Vienna and at Lainz Hospital report, patients with

early therapy were doing better than those who had waited longer.

This continued over the course of the study, with the early-treatment group

showing a disease activity score improvement of 2.8, versus 1.7 for those in

the later-treatment group.

And at the end of the study, 70% of patients in the early-treatment group

fulfilled American College of Rheumatology criteria for a 20% improvement in

disease symptoms, while 40% of those in the later treatment group did. Three

years after treatment began, 7 people in the early-treatment group showed

evidence of bone damage on x-rays, versus 15 of the later-treatment group

patients.

The researchers told the EULAR congress in Stockholm, Sweden, that their

results showed that introducing disease-modifying drugs very early " seems

highly beneficial in (rheumatoid arthritis) compared with even relatively

short delay. Thus, early diagnosis and therapy is the crucial step in

achieving better control of disease progression and prognosis in (rheumatoid

arthritis). "