RESEARCH - Attitudes to early RA: changing patterns. Results of a survey.

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Ann Rheum Dis. 2004 Oct;63(10):1269-75.

Attitudes to early rheumatoid arthritis: changing patterns. Results of a

survey.

Aletaha D, Eberl G, Nell VP, Machold KP, Smolen JS.

Division of Rheumatology, Department of Internal Medicine III,

University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20,

A-1090 Vienna, Austria. daniel.aletaha@...

OBJECTIVE: To determine if rheumatologists have changed their views on

diagnosis and treatment of early rheumatoid arthritis (RA). METHODS:

Three consecutive questionnaires were sent out to international

rheumatologists in 1997, 2000, and 2003. The following aspects of early

RA were covered: definition; patient referral time; diagnostic means;

follow up intervals; and treatment strategies. All initial participants

who responded to at least one of the follow up surveys were included in

the analysis. RESULTS: RA is now defined by a smaller number of affected

joints (monarthritis: 9.8% respondents in 1997 v 17.4% in 2003), and

shorter symptom duration (<3 months: 65.5% in 1997 v 85.8% in 2003).

Early referrals (<6 weeks) increased (8.9% in 1997 v 17.4% in 2003).

Serological test for diagnosis was mostly rheumatoid factor (100% in

2003), but anti-CCP was already used by 17.4% in 2003. Follow up of

patients with early RA intensified (every 2 weeks: 16.1% in 1997 v 30.4%

in 2003; every month: 47.8% in 2003 v 64.3% in 1997). Treatment with

disease modifying antirheumatic drugs (DMARDs) mainly comprised

methotrexate, sulfasalazine, and antimalarial drugs. Leflunomide was

among the two favourite DMARDs of 10.9% in 2003, whereas no biological

agent was so. In 2003, 46.7% respondents started treatment with DMARDs

if RA was suspected (30.9% in 1997); no one waited for erosions to occur

(7.3% in 1997).

CONCLUSION: The data obtained in this study suggest that the concept of

diagnosing and treating RA early is accepted by a large proportion of

the rheumatological community.

PMID: 15361385

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5361385 & dopt=Abstract

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