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Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985
Article first published online: 7 APR 2005
DOI: 10.1002/art.20941
Copyright © 2005 by the American College of Rheumatology
Additional Information
How to Cite
Pincus, T., Sokka, T. and Kautiainen, H. (2005), Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985. Arthritis & Rheumatism, 52: 1009–1019. doi: 10.1002/art.20941
Publication History
- Issue published online: 7 APR 2005
- Article first published online: 7 APR 2005
- Manuscript Accepted: 13 DEC 2004
- Manuscript Received: 23 MAR 2004
Funded by
- Abbott Immunology
- Amgen
- Arthritis Foundation
- Aventis
- Centocor
- Pfizer
- Jack C. Massey Foundation
- Academy of Finland
- NIH. Grant Number: HL-67964
REFERENCES
- 1, . Remodeling the pyramid: a concept whose time has come. J Rheumatol 1989; 16: 565–7.
- 2, . Reassessment of twelve traditional paradigms concerning the diagnosis, prevalence, morbidity and mortality of rheumatoid arthritis. Scand J Rheumatol 1989; 18 Suppl 79: 67–96.
- 3. Reevaluating the therapeutic approach to rheumatoid arthritis: the “sawtooth” strategy. J Rheumatol 1990; 17 Suppl 22: 12–5.
- 4. The case for early intervention in rheumatoid arthritis. J Autoimmun 1992; 5 Suppl A: 209–26.
- 5
- 6, . Early rheumatoid arthritis: time to aim for remission? Ann Rheum Dis 1995; 54: 944–7.
- 7. Rheumatoid arthritis: treat now, not later! [editorial]. Ann Intern Med 1996; 124: 773–4.
- 8, , , , , , et al. Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med 1985; 312: 818–22.
- 9, , . Combination therapy with multiple disease-modifying antirheumatic drugs in rheumatoid arthritis: a preventive strategy. Ann Intern Med 1999; 131: 768–74.
- 10, , , , , . Lower disease activity and disability in Swedish patients with rheumatoid arthritis in 1995 compared with 1978. Scand J Rheumatol 1999; 28: 160–5.
- 11, , , , , , et al. Is rheumatoid arthritis becoming a milder disease? Or are we starting second-line therapy in patients with milder disease? Br J Rheumatol 1996; 35: 1305–8.
- 12, . Reduction in long-term functional disability in rheumatoid arthritis from 1977 to 1998: a longitudinal study of 3035 patients. Am J Med 2003; 115: 371–6.
- 13, . Long-term outcome of rheumatoid arthritis has improved. Scand J Rheumatol 1994; 23: 13–5.
- 14, , , . Conventional monotherapy compared with a “sawtooth” treatment strategy in the radiographic procession of rheumatoid arthritis over the first eight years. Clin Exp Rheumatol 1999; 17: 527–32.
- 15, , , . Radiographic progression is getting milder in patients with early rheumatoid arthritis: results of 3 cohorts over 5 years. J Rheumatol 2004; 31: 1073–82.
- 16, , , . Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis. Arthritis Rheum 2000; 43: 14–21.Direct Link:
- 17, , , , . Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 2002; 359: 1173–7.
- 18, . Eligibility of patients in routine care for major clinical trials of anti–tumor necrosis factor α agents in rheumatoid arthritis. Arthritis Rheum 2003; 48: 313–8.Direct Link:
- 19, . Most patients receiving routine care for rheumatoid arthritis in 2001 did not meet inclusion criteria for most recent clinical trials or American College of Rheumatology criteria for remission. J Rheumatol 2003; 30: 1138–46.
- 20, , , , , , et al. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)-Fc fusion protein. N Engl J Med 1997; 337: 141–7.
- 21, , , , , , et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. N Engl J Med 2000; 343: 1594–602.
- 22, , , , , , et al. Treatment of rheumatoid arthritis with recombinant human interleukin-1 receptor antagonist. Arthritis Rheum 1998; 41: 2196–204.Direct Link:
- 23, , , , , , et al. Adalimumab, a fully human anti–tumor necrosis factor α monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum 2003; 48: 35–45.Direct Link:
- 24, , , , , , et al. The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. Arthritis Rheum 1993; 36: 729–40.Direct Link:
- 25, , , . Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 1993; 20: 579–81.
- 26, , . Interpretation and power of pooled index. J Rheumatol 1993; 20: 575–8.
- 27, , , , , . Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis Rheum 1984; 27: 864–72.Direct Link:
- 28, . Sensitivity to change of the Health Assessment Questionnaire (HAQ) and other clinical and health status measures in rheumatoid arthritis: results of short-term clinical trials and observational studies versus long-term observational studies. Arthritis Care Res 1992; 5: 130–6.Direct Link:
- 29, , , . The progression of erosion and joint space narrowing scores in rheumatoid arthritis during the first twenty-five years of disease. Arthritis Rheum 1991; 34: 660–8.Direct Link:
- 30, , , , , , et al. Patients with rheumatoid arthritis benefit from early 2nd line therapy: 5 year followup of a prospective double blind placebo controlled study. J Rheumatol 1995; 22: 2208–13.
- 31, , , . Development of radiographic damage during the first 5-6 yr of rheumatoid arthritis: a prospective follow-up study of a Swedish cohort. Br J Rheumatol 1996; 35: 1106–15.
- 32, , . Clinical improvement and radiological deterioration in rheumatoid arthritis: evidence that pathogenesis of synovial inflammation and articular erosion may differ. Br J Rheumatol 1996; 35: 1263–8.
- 33, , , , , . Measures of activity and damage in rheumatoid arthritis: depiction of changes and prediction of mortality over five years. Arthritis Care Res 1997; 10: 381–94.Direct Link:
- 34, , , , , , et al. Inflammatory patterns in rheumatoid arthritis estimated by the number of swollen and tender joints, the erythrocyte sedimentation rate, and hemoglobin: longterm course and association to radiographic progression. J Rheumatol 2000; 27: 47–57.
- 35, , , . A 10 year prospective followup of patients with rheumatoid arthritis 1986-96. J Rheumatol 2001; 28: 2400–8.
- 36, , , , . The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum 2001; 44: 2009–17.Direct Link:
- 37, . Partial control of core data set measures and Disease Activity Score (DAS) measures of inflammation does not prevent long-term damage: evidence from longitudinal observations over 5-20 years. Clin Exp Rheumatol 2002; 20 Suppl 27: S42–8.
- 38, . An infrastructure of patient questionnaires at each rheumatology visit: improving efficiency and documenting care. J Rheumatol 2000; 27: 2727–30.
- 39. A data bank for the clinician? [editorial]. N Engl J Med 1976; 294: 1400–2.
- 40. The series of consecutive cases as a device for assessing outcomes of intervention. N Engl J Med 1984; 311: 705–10.
- 41, , , . A simplified twenty-eight–joint quantitative articular index in rheumatoid arthritis. Arthritis Rheum 1989; 32: 531–7.Direct Link:
- 42, , , , , . Radiographic and joint count findings of the hand in rheumatoid arthritis: related and unrelated findings. Arthritis Rheum 1988; 31: 44–51.Direct Link:
- 43, , , , . Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease. J Rheumatol 1989; 16: 585–91.
- 44, , , , , , et al. Associations of HLA-DR4 with rheumatoid factor and radiographic severity in rheumatoid arthritis. Am J Med 1988; 84: 257–64.
- 45, . Rheumatology function tests: grip strength, walking time, button test and questionnaires document and predict longterm morbidity and mortality in rheumatoid arthritis. J Rheumatol 1992; 19: 1051–7.
- 46, , , , , . Self-report questionnaire scores in rheumatoid arthritis compared with traditional physical, radiographic, and laboratory measures. Ann Intern Med 1989; 110: 259–66.
- 47, , , , , , et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315–24.Direct Link:
- 48, , . Questionnaire, walking time and button test measures of functional capacity as predictive markers for mortality in rheumatoid arthritis. J Rheumatol 1987; 14: 240–51.
- 49, , . Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med 1994; 120: 26–34.
- 50, , , . Measurement of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137–45.Direct Link:
- 51, , , , . Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum 1983; 26: 1346–53.Direct Link:
- 52, , . Toward a Multidimensional Health Assessment Questionnaire (MDHAQ): assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis Rheum 1999; 42: 2220–30.Direct Link:
- 53, , . Reliability of grip strength, walking time and button test performed according to a standard protocol. J Rheumatol 1991; 18: 997–1000.
- 54, . Listening to the patient: a practical guide to self-report questionnaires in clinical care. Arthritis Rheum 1999; 42: 1797–808.Direct Link:
- 55, , . A proposed standard protocol to evaluate rheumatoid arthritis (SPERA) that includes measures of inflammatory activity, joint damage, and longterm outcomes. JRheumatol 1999; 26: 473–80.
- 56, , , , , . Modified disease activity scores that include twenty-eight–joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995; 38: 44–8.Direct Link:
- 57, , . Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977; 18: 481–91.
- 58, . Reply to: Swollen joint count as a predictor of response to anti–tumor necrosis factor α therapy in rheumatoid arthritis: comment on the article by Sokka and Pincus [letter]. Arthritis Rheum 2003; 48: 3613–5.Direct Link:
- 59, , , , , , et al. Retardation of joint damage in patients with early rheumatoid arthritis by initial aggressive treatment with disease-modifying antirheumatic drugs: five-year experience from the FIN-RACo study. Arthritis Rheum 2004; 50: 2072–81.Direct Link:
- 60, , , , , , et al, and the FIN-RACo trial group. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomised trial. Lancet 1999; 353: 1568–73.
- 61, , , , , , et al. Etanercept versus methotrexate in patients with early rheumatoid arthritis: two-year radiographic and clinical outcomes. Arthritis Rheum 2002; 46: 1443–50.Direct Link:
- 62, , , , , , et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 2004; 364: 263–9.
- 63, . Placebo-controlled studies in rheumatoid arthritis: ethical issues. Lancet 1999; 353: 400–3.
- 64, , , . The importance of β, the type II error and sample size in the design and interpretation of the randomized control trial: survey of 71 “negative” trials. N Engl J Med 1978; 299: 690–4.
- 65, . Controversy in counting and attributing events in clinical trials. N Engl J Med 1979; 301: 1410–2.
- 66. The randomized clinical trial as an obstacle to clinical research. In: VarcoRL, DelaneyJP, editors. Controversy in surgery. Philadelphia: WB Saunders; 1983. p. 5–12.
- 67. An additional basic science for clinical medicine. II. The limitations of randomized trials. Ann Intern Med 1983; 99: 544–50.
- 68, . Clinical trials and statistical verdicts: probable grounds for appeal. Ann Intern Med 1983; 98: 385–94.
- 69, , , . Bias in treatment assignment in controlled clinical trials. N Engl J Med 1983; 309: 1358–61.
- 70, . Controversies in the analysis of longterm clinical trials of slow acting drugs [editorial]. J Rheumatol 1985; 12: 403–5.
- 71. Rheumatoid arthritis: disappointing long-term outcomes despite successful short-term clinical trials. J Clin Epidemiol 1988; 41: 1037–41.
- 72. Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroidal antiinflammatory drugs in rheumatoid arthritis. Control Clin Trials 1989; 10: 31–56.
- 73, , . Time for changes in the design, analysis, and reporting of rheumatoid arthritis clinical trials [review]. Arthritis Rheum 1990; 33: 140–9.Direct Link:
- 74, . Are the results of controlled clinical trials and observational studies of second line therapy in rheumatoid arthritis valid and generalizable as measures of rheumatoid arthritis outcome: analysis of 122 studies. J Rheumatol 1991; 18: 1008–14.
- 75. Limitations of randomized controlled clinical trials to recognize possible advantages of combination therapies in rheumatic diseases. Semin Arthritis Rheum 1993; 23 Suppl 1: 2–10.
- 76, . Why randomized controlled clinical trials do not depict accurately long-term outcomes in rheumatoid arthritis: some explanations and suggestions for future studies. Clin Exp Rheumatol 1997; 15 Suppl 17: S27–38.
- 77, . Problems in the “evidence” of “evidence-based medicine.” Am J Med 1997; 103: 529–35.
- 78. Clinical versus statistical considerations in the design and analysis of clinical research. J Clin Epidemiol 1998; 51: 305–7.
- 79, , . Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med 2000; 342: 1887–92.
- 80, , . Results from controlled clinical trials: how relevant for clinical practice? J Rheumatol 2003; 30: 1135–7.
- 81, , , . Work disability in rheumatoid arthritis: effects of disease, social, and work factors. Ann Intern Med 1980; 93: 551–6.
- 82, , , , , . Progression of radiological changes in rheumatoid arthritis. Ann Rheum Dis 1984; 43: 8–17.
- 83, , . Death rate and causes of death in patients with rheumatoid arthritis. Scand J Rheumatol 1975; 4: 205–8.
- 84. Methotrexate therapy in rheumatoid arthritis: 15 years experience. Am J Med 1983; 75 Suppl 6A: 69–73.
- 85, , , , . Patient questionnaires and formal education level as prospective predictors of mortality over 10 years in 97% of 1416 patients with rheumatoid arthritis from 15 United States private practices. J Rheumatol 2004; 31: 229–34.
- 86, . The ‘side effects’ of rheumatoid arthritis: joint destruction, disability and early mortality. Br J Rheumatol 1993; 32 Suppl 1: 28–37.
- 87, , , . Is rheumatoid arthritis becoming less severe? J Chronic Dis 1983; 36: 891–7.
- 88, , , , , . Is seropositive rheumatoid arthritis becoming less severe? Clin Exp Rheumatol 1989; 7: 287–90.
- 89, , . Prevalence of rheumatoid arthritis and rheumatoid factor in women: evidence for a secular decline. Ann Rheum Dis 1993; 52: 254–7.
- 90. The changing face of rheumatoid arthritis: why the decline in incidence? [editorial]. Arthritis Rheum 2002; 46: 579–81.Direct Link:

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