Re: The need for early, agressive treatment in RA

[Guest guest]

Thanks for this !

The one link said this... " patients should be started on a single

DMARD therapy within the first 2-4 months of symptom onset, this

being rapidly stepped up with regard to both dose and the addition

of other conventional DMARDs, in an attempt to suppress all disease

activity. Nothing less than the attainment of no evidence of disease

(NED) is acceptable because inflammation needs to be thought of as

an inherently damaging process if left to its own devices. "

This is exactly how my rheumy reacts and how I believe you have to

treat RA. My rheumy called the period from when symptoms started

until he diagnosed me as the time when " RA was brewing, but not

fully there yet " I always knew the diagnosis was coming, mostly

because my mom has severe RA. I could call her and describe how I

was feeling, and she would say, yep, she knew exactly how I felt.

In any case, she would worry my rheumy wasn't treating my RA

aggressively enough, but I would say to her, I don't have any

swelling, the drugs I am on are controlling that and therefore I am

not likely to have joint damage occuring now. That is always the

measurement for me. No swelling, meds are good, swelling, need to

get more/stronger meds.

> ******************************

>

> Medscape

> Dr. Frederick Wolfe

>

> " Early Aggressive Therapy for Rheumatoid Arthritis " :

> http://www.medscape.com/viewarticle/429757_2

>

>

> ******************************

>

> Theodore R. Fields, MD, FACP

> Internet Project Director, HSS Division of Rheumatology

> Director, HSS Rheumatology Faculty Practice Plan

> Associate Professor of Clinical Medicine, Weill Medical College of

> Cornell University

>

>

> " ACR Special Report: Can tight control of early RA with a DAS

target

> yield significantly better outcomes? " :

>

http://rheumatology.hss.edu/phys/specialReports/fields_controlRA.asp

> (November 4, 2003)

>

> ******************************

>

> A. Paget, MD

> Physician-in-Chief and Chairman of the Division of Rheumatology

> Hospital for Special Surgery

>

>

> " Lower the Thermostat - the Heat is Too High: Winning the Battle

and the

> War " :

> http://rheumatology.hss.edu/phys/musings/thermostat.asp

> (August 11, 2003)

>

>

> " Musings: New Standards of Treatment for Early Rheumatoid

Arthritis " :

> http://rheumatology.hss.edu/phys/musings/pagetRA.asp

> (October 15, 2003)

>

>

> " Musings: New Standards of Treatment for Difficult RA - Part 1 " :

> http://rheumatology.hss.edu/phys/musings/pagetStandardsRA.asp

> (November 13, 2003)

>

> ******************************

>

> Journal of Rheumatology

> March 2004

> L.

>

> " Radiological Progression in Established Rheumatoid Arthritis " :

> http://jrheum.com/subscribers/04/03/supplement/55.html

>

>

> ******************************

>

>

>

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org