Patients with suspected rheumatoid arthritis should be referred early to rheumatology

doi:10.1136/bmj.39381.597454.AE

BMJ 2008;336:215-216 (26 January), doi:10.1136/bmj.39381.597454.AE

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Patients with suspected rheumatoid arthritis should be referred early to rheumatology

Kimme L Hyrich, clinical lecturer and consultant in rheumatology¹

¹ ARC Epidemiology Unit, University of Manchester, Manchester M13 9PT

kimme.hyrich@manchester.ac.uk

The first 150 words of the full text of this article appear below.

Early treatment of rheumatoid arthritis resultsin better long term outcomes

Patients with suspected rheumatoidarthritis should start treatment with disease modifying anti-rheumaticdrugs (DMARDs) as soon as possible, ideally within three monthsof onset

Most patients with rheumatoid arthritis do not receiveDMARD treatment within three months of onset

Delay is probablydue to a combination of patient related and physician relatedfactors

Rheumatoid arthritis affects 1% of adults and is associatedwith progressive joint damage and disability and increased mortality.Treatment with disease modifying anti-rheumatic drugs (DMARDs),such as methotrexate, has been shown to reduce the progressionof radiologically evident joint damage and improve long termdisability. A shift towards starting DMARD treatment as earlyas possible has therefore occurred. Guidelines recommend thatpatients should be referred early, ideally within six weeksof the onset of symptoms,¹ and that DMARDs should be startedwithin 12 weeks of onset.² . . . [Full text of this article]

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Fautrel, B., Benhamou, M., Foltz, V., Rincheval, N., Rat, A.-C., Combe, B., Berenbaum, F., Bourgeois, P., Guillemin, F. (2009). Early referral to the rheumatologist for early arthritis patients: evidence for suboptimal care. Results from the ESPOIR cohort. Rheumatology (Oxford) 0: kep340v1-kep340 [Abstract] [Full text]