Rheumatoid Arthritis Drugs Improving Health

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Rheumatoid Arthritis Drugs Improving Health

Body Organ Damage, Need for Hospital Decreasing

By Jeanie Lerche

April 9, 2004 -- Drugs for rheumatoid arthritis have significantly improved

long-term health of people living with the disease. Currently, there are

fewer people are being hospitalized for severe complications associated with

RA, new research shows.

It's a big advance since the 1980s, when disease modifying drugs -- used to

slow progression of the disease rather than just decrease pain -- first

arrived on the scene, writes researcher M. Ward, MD, MPH, with the

National Institute of Arthritis and Musculoskeletal and Skin Diseases.

His report appears in the April issue of the journal Arthritis & Rheumatism.

Joint destruction occurs early in the course of rheumatoid arthritis. In

recent years, disease- modifying drugs have been started as the first course

of action when rheumatoid arthritis is diagnosed, Ward says. But there's

been little study of the drugs' effect on a patient's long-term health. Do

they actually prevent the more severe complications of rheumatoid arthritis

- such as the neck instability that can lead to pressure on the upper parts

of the spinal cord or the destructive knee arthritis that can lead to total

knee replacement?

Ward's study looked at hospitalization rates for severe complications

related to rheumatoid arthritis problems from 1983 to 2001 in California

hospitals. He found that hospitalizations for:

* Damage to critical organs - such as the kidneys, brain, and heart --

from blood vessel inflammation (called vasculitis) decreased significantly.

* Spleen removal caused by Felty's syndrome -- a condition seen

sometimes with severe rheumatoid -- decreased by 71%.

* Total knee replacement surgery progressively increased up until 1997

and then decreased from 1997 until 2001. The findings regarding knee

replacement surgery may not be completely accurate, Ward says, because the

knee arthritis in some people may have been caused by osteoarthritis, not

rheumatoid arthritis.

Hospitalizations for surgeries to stabilize the neck in people with

rheumatoid arthritis did not decrease. However, since that surgery is

relatively infrequent, the numbers may be somewhat skewed, he says.

Overall, the trend shows that the long-term health of patients with

rheumatoid arthritis have improved during the past 19 years, Ward says. New

drug treatments for related conditions -- as well as the trend toward

outpatient treatment -- have further chipped at the need for

hospitalization.

SOURCE: Ward, M.Arthritis & Rheumatism, April 2004; vol 50: pp 1122-1131.