M e t h o d s Design: Randomized controlled trial (Finnish Rheumatoid Arthritis Combination Therapy trial). Allocation: {Concealed}†.* Blinding: Blinded {outcome assessors}†.* Follow-up period: 5 years. Setting: 18 hospitals in Finland. Patients: 162 patients 18 to 65 years of age (mean age 45.5 y, 62% women) with RA of recent onset (< 2 y) and presence of active disease who had never received ...

OBJECTIVES After treatment failure with a tumor necrosis factor inhibitor (TNFi), patients with rheumatoid arthritis (RA) can switch to another TNFi (TNFi cyclers) or to a targeted disease-modifying antirheumatic drug (DMARD) with a non-TNFi mechanism of action (non-TNFi switchers). This study compared treatment patterns and treatment effectiveness between TNFi cyclers and non-TNFi switchers in...

OBJECTIVE Although early initiation of disease-modifying antirheumatic drugs (DMARDs) is effective in controlling short-term joint damage in individuals with rheumatoid arthritis (RA), the long-term benefit in disease progression is still controversial. We examined the long-term benefit of early DMARD initiation on radiographic progression in early RA. METHODS We identified published and unpu...

Chronic viral infections in rheumatic patients are a diagnostic and therapeutic challenge. Some of the disease-modifying antirheumatic drugs (DMARD) commonly used in rheumatoid arthritis, such as methotrexate and leflunomide, are hepatotoxic. With biological therapy, which is now widely used in patients refractory to these and other DMARD, some cases of reactivation of hepatitis B, even fulmina...

The European League Against Rheumatism (EULAR) recommends that treatment of RA be considered in three phases [1]. Phase I should start immediately after diagnosis of RA, with patients recommended to receive synthetic DMARDs such as MTX, with or without the addition of glucocorticoids. Response to this anchor therapy should be monitored regularly (every 1 3 months), with the aim of achieving rem...

OBJECTIVE To explore the influence of anti-tumor necrosis factor (anti-TNF) therapy upon the incidence of cancer in patients with rheumatoid arthritis (RA) and prior malignancy. METHODS Using data from the British Society for Rheumatology Biologics Register, a national prospective observational study established in 2001, we identified 293 patients with a prior malignancy from over 14,000 pati...

OBJECTIVE Poor adherence to therapy increases the patient and societal burden and complexity of chronic diseases such as rheumatoid arthritis (RA). In the past 15 years, biologic disease-modifying anti-rheumatic drugs (DMARDs) have revolutionized the treatment of RA. However, little data are available on the impact of adherence to biologics on health care resources. The objective of the study w...

BACKGROUND Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and joint structural deterioration. Driven by recent expectations that patients in clinical trials randomized to placebo should be 'rescued' with active therapy within 6 months of starting treatment, the relative benefit of arresting joint damage with biologic agents beyond this period is unclear....

OBJECTIVE To evaluate the long-term frequency of disease remissions and the progression of joint damage in patients with early rheumatoid arthritis (RA) who were initially randomized to 2 years of treatment with either a combination of 3 disease-modifying antirheumatic drugs (DMARDs) or a single DMARD. METHODS In this multicenter prospective followup study, a cohort of 195 patients with early...

UNLABELLED BACKGROUND Variations in the treatment of juvenile idiopathic arthritis (JIA) may impact on quality of care. The objective of this study was to identify and compare treatment approaches for JIA in two health care systems. METHODS Paediatric rheumatologists in Canada (n=58) and Germany/Austria (n=172) were surveyed by email, using case-based vignettes for oligoarticular and seron...