Disease modifying drugs in rheumatoid arthritis

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7083.766 (Published 15 March 1997) Cite this as: BMJ 1997;314:766

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Encouraging signs but effects not proved

  1. Frank A Wollheim, Professora
  1. a Department of Rheumatology, Lund University Hospital, S-221 85 Lund, Sweden

    Despite extensive research rheumatoid arthritis continues to cause suffering, disability, economic loss, and premature death. New approaches to treatment include immunotherapy, targeting cell surface structures, cell functions, cytokines, and adhesion molecules known to have a role in the inflammatory reaction.1 However, the clinical controversy is whether to treat every patient soon after onset with disease modifying drugs. These include antimalarials, sulphasalazine, d-penicillamine, oral and parenteral gold, and methotrexate.

    Recent support for early aggressive treatment has come from an open randomised study of very early cases from several centres in the Netherlands. The investigators compared treatment with several disease modifying drugs and with non-steroidal anti-inflammatory drugs. The results after one year showed that the patients given disease modifying drugs had lower sedimentation rates and had also done better on most clinical measures of disease activity. …

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