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Titolo:
The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence?
Autore:
Quinn, MA; Conaghan, PG; Emery, P;
Indirizzi:
Univ Leeds, Rheumatol & Rehabil Res Unit, Leeds LS2 9NZ, W Yorkshire, England Univ Leeds Leeds W Yorkshire England LS2 9NZ S2 9NZ, W Yorkshire, England
Titolo Testata:
RHEUMATOLOGY
fascicolo: 11, volume: 40, anno: 2001,
pagine: 1211 - 1220
SICI:
1462-0324(200111)40:11<1211:TTAOEI>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
C-REACTIVE PROTEIN; RANDOMIZED CONTROLLED TRIAL; STEP-DOWN PREDNISOLONE; GOLD SODIUM THIOMALATE; LOW-DOSE CYCLOSPORINE; WEEK CLINICAL-TRIAL; DOUBLE-BLIND; COMBINATION THERAPY; JOINT DESTRUCTION; ANTIRHEUMATIC DRUGS;
Keywords:
early rheumatoid arthritis; combination therapy; corticosteroids; DMARDS; anti-TNF-alpha agents;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
66
Recensione:
Indirizzi per estratti:
Indirizzo: Emery, P Univ Leeds, Rheumatol & Rehabil Res Unit, 36 Clarendon Rd, Leeds LS2 9NZ, W Yorkshire, England Univ Leeds 36 Clarendon Rd Leeds W Yorkshire England LS2 9NZ land
Citazione:
M.A. Quinn et al., "The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence?", RHEUMATOLOG, 40(11), 2001, pp. 1211-1220

Abstract

Objective. The concepts of early intervention and early arthritis clinics for the management of rheumatoid arthritis (RA) were introduced almost a decade ago. The evidence for these is diverse and the best therapeutic approach remains vehemently debated. This review addresses these issues,Methods. The MEDLINE database was searched to identify relevant papers satisfying inclusion criteria for disease duration and no previous use of disease-modifying anti-rheumatic drugs (DMARDs). Where possible. evidence was obtained from randomized controlled trials. We selected the most relevant topics to best justify early therapeutic intervention in RA. Results. The benefit of DMARDs over placebo and delayed therapy is unquestionable from the studies presented, with reduction in bone damage and preservation of function. Through prevention of disability, early treatment should be the most cost-effective approach. The evidence presented supports theuse of DMARDs when the diagnosis of RA is first made. Delay in treatment may result in irreversible damage. There is insufficient evidence to recommend combination therapy for all patients at disease onset. Further research into newer therapies is required before their routine first-line use is recommended. Conclusions. Early therapeutic intervention in RA reduces long-term disability and joint damage. Optimal management appears to be the early identification of non-responders and targeted combination therapy. Biological therapies have the potential to revolutionize the treatment of early RA.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 10:32:31