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Timing in Treating Rheumatoid Arthritis
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A group of Canadian researchers say that a diagnosis of rheumatoid arthritis requires prompt medical attention, and that initial treatment should include medications considered "second line therapy" drugs that work to check the spread of the arthritis rather than just control symptoms of pain and stiffness. The authors say that there is likely a "window of opportunity" early in the progression of the disease when aggressive medical treatment stands a better chance of slowing the spread of the disease.
An article in a recent issue of the Journal of Rheumatology* suggests that the type of treatment people with rheumatoid arthritis receive when their symptoms first become apparent can have a crucial impact on how fast the disease progresses.
To prove this point, the researchers kept track of more than 100 people with rheumatoid arthritis who had been part of a nine-month study that assessed the effectiveness of one "second line" medication. All study participants were newly diagnosed with rheumatoid arthritis, but only half received the medication during the study.
At the study's conclusion, everyone was started on medication, but even after three years of treatment, the people who did not receive the drug until the end of the study suffered significantly more joint pain and stiffness than those who had received the drug immediately after diagnosis. The researchers note that the people who delayed treatment for the nine-month period of the study likely missed that early "window of opportunity" when the medication would have been most effective.
* Tsakonas E, Fitzgerald A, Fitzcharles MA, et al. "Consequences of delayed therapy with second-line agents in rheumatoid arthritis: a 3-year follow-up on the Hydroxychloroquine in early rheumatoid arthritis (HERA) study." Journal of Rheumatology, March 2000, Volume 27, pp 623-629.
by Jean Baker, MS, RD
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