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Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): A randomized, controlled trial

  1. Y. P. M. Goekoop-Ruiterman1,†,*,
  2. J. K. De Vries-Bouwstra2,†,
  3. C. F. Allaart1,
  4. D. Van Zeben3,
  5. P. J. S. M. Kerstens4,
  6. J. M. W. Hazes5,
  7. A. H. Zwinderman6,
  8. H. K. Ronday7,
  9. K. H. Han8,
  10. M. L. Westedt9,
  11. A. H. Gerards10,
  12. J. H. L. M. Van Groenendael11,
  13. W. F. Lems12,
  14. M. V. Van Krugten13,
  15. F. C. Breedveld1,‡,
  16. B. A. C. Dijkmans14

Article first published online: 28 OCT 2005

DOI: 10.1002/art.21405

Issue

Arthritis & Rheumatism

Arthritis & Rheumatism

Volume 52, Issue 11, pages 3381–3390, November 2005

Additional Information

How to Cite

Goekoop-Ruiterman, Y. P. M., De Vries-Bouwstra, J. K., Allaart, C. F., Van Zeben, D., Kerstens, P. J. S. M., Hazes, J. M. W., Zwinderman, A. H., Ronday, H. K., Han, K. H., Westedt, M. L., Gerards, A. H., Van Groenendael, J. H. L. M., Lems, W. F., Van Krugten, M. V., Breedveld, F. C. and Dijkmans, B. A. C. (2005), Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): A randomized, controlled trial. Arthritis & Rheumatism, 52: 3381–3390. doi: 10.1002/art.21405

Author Information

  1. 1

    Leiden University Medical Center, Leiden, The Netherlands

  2. 2

    VU Medical Center, Amsterdam, The Netherlands

  3. 3

    Sint Franciscus Gasthuis, Rotterdam, The Netherlands

  4. 4

    Jan van Breemen Institute, Amsterdam, The Netherlands

  5. 5

    Erasmus Medical Center, Rotterdam, The Netherlands

  6. 6

    Academic Medical Center, Amsterdam, The Netherlands

  7. 7

    Haga Hospital, The Hague, The Netherlands

  8. 8

    Medical Center Rijnmond-Zuid, Rotterdam, The Netherlands

  9. 9

    Bronovo Hospital, The Hague, The Netherlands

  10. 10

    Vlietland Hospital, Schiedam, The Netherlands

  11. 11

    Franciscus Hospital, Roosendaal, The Netherlands

  12. 12

    Slotervaart Hospital, Amsterdam, The Netherlands

  13. 13

    Walcheren Hospital, Vlissingen, The Netherlands

  14. 14

    VU Medical Center, and Jan van Breemen Institute, Amsterdam, The Netherlands

  1. †

    Drs. Goekoop-Ruiterman and de Vries-Bouwstra contributed equally to this work.

  2. ‡

    Dr. Breedveld has received consultancy fees or honoraria (less than $10,000 per year) from Schering-Plough BV.

*Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands

Publication History

  1. Issue published online: 28 OCT 2005
  2. Article first published online: 28 OCT 2005
  3. Manuscript Accepted: 9 AUG 2005
  4. Manuscript Received: 14 MAR 2005

Funded by

  • Dutch College of Health Insurances
  • Schering-Plough BV
  • Centocor Inc.

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REFERENCES

  • 1
    Bukhari MA, Wiles NJ, Lunt M, Harrison BJ, Scott DG, Symmons DP, et al. Influence of disease-modifying therapy on radiographic outcome in inflammatory polyarthritis at five years: results from a large observational inception study. Arthritis Rheum 2003; 48: 46–53.
    Direct Link:
  • 2
    Egsmose C, Lund B, Borg G, Pettersson H, Berg E, Brodin U, et al. Patients with rheumatoid arthritis benefit from early second line therapy: 5-year follow-up of a prospective double-blind placebo-controlled study. J Rheumatol 1995; 22: 2208–13.
  • 3
    Lard LR, Visser H, Speyer I, van der Horst-Bruinsma IE, Zwinderman AH, Breedveld FC, et al. Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med 2001; 111: 446–51.
  • 4
    Mottonen T, Hannonen P, Korpela M, Nissila M, Kautiainen H, Ilonen J, et al. Delay to institution of therapy and induction of remission using single-drug or combination–disease-modifying antirheumatic drug therapy in early rheumatoid arthritis. Arthritis Rheum 2002; 46: 894–8.
    Direct Link:
  • 5
    Van der Heide A, Jacobs JW, Bijlsma JW, Heurkens AH, Booma-Frankfort C, van der Veen MJ, et al. The effectiveness of early treatment with “second-line” antirheumatic drugs: a randomized, controlled trial. Ann Intern Med 1996; 124: 699–707.
  • 6
    Fries JF. Reevaluating the therapeutic approach to rheumatoid arthritis: the “sawtooth” strategy. J Rheumatol 1990; 17: 12–5.
  • 7
    Fries JF, Williams CA, Morfeld D, Singh G, Sibley J. Reduction in long-term disability in patients with rheumatoid arthritis by disease-modifying antirheumatic drug–based treatment strategies. Arthritis Rheum 1996; 39: 616–22.
    Direct Link:
  • 8
    Sokka T, Mottonen T, Hannonen P. Disease-modifying anti-rheumatic drug use according to the ‘sawtooth’ treatment strategy improves the functional outcome in rheumatoid arthritis: results of a long-term follow-up study with review of the literature. Rheumatology (Oxford) 2000; 39: 34–42.
  • 9
    Boers M, Verhoeven AC, Markusse HM, van de Laar MA, Westhovens R, van Denderen JC, et al. Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis [published erratum appears in Lancet 1998;351:220]. Lancet 1997; 350: 309–18.
  • 10
    Calguneri M, Pay S, Caliskaner Z, Apras S, Kiraz S, Ertenli I, et al. Combination therapy versus monotherapy for the treatment of patients with rheumatoid arthritis. Clin Exp Rheumatol 1999; 17: 699–704.
  • 11
    Landewe RB, Boers M, Verhoeven AC, Westhovens R, van de Laar MA, Markusse HM, et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum 2002; 46: 347–56.
    Direct Link:
  • 12
    Mottonen T, Hannonen P, Leirisalo-Repo M, Nissila M, Kautiainen H, Korpela M, et al, and the FIN-RACo trial group. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomized trial. Lancet 1999; 353: 1568–73.
  • 13
    Gerards AH, Landewe RB, Prins AP, Bruijn GA, The HS, Laan RF, et al. Cyclosporin A monotherapy versus cyclosporin A and methotrexate combination therapy in patients with early rheumatoid arthritis: a double blind randomized placebo controlled trial. Ann Rheum Dis 2003; 62: 291–6.
  • 14
    Marchesoni A, Battafarano N, Arreghini M, Panni B, Gallazzi M, Tosi S. Radiographic progression in early rheumatoid arthritis: a 12-month randomized controlled study comparing the combination of cyclosporin and methotrexate with methotrexate alone. Rheumatology (Oxford) 2003; 42: 1545–9.
  • 15
    Breedveld FC, Emery P, Keystone E, Patel K, Furst DE, Kalden JR, et al. Infliximab in active early rheumatoid arthritis. Ann Rheum Dis 2004; 63: 149–55.
  • 16
    Genovese MC, Bathon JM, Martin RW, Fleischmann RM, Tesser JR, Schiff MH, 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:
  • 17
    StClair EW, van der Heijde DM, Smolen JS, Maini RN, Bathon JM, Emery P, et al. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum 2004; 50: 3432–43.
    Direct Link:
  • 18
    O'Dell JR, Haire CE, Erikson N, Drymalski W, Palmer W, Eckhoff PJ, et al. Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N Engl J Med 1996; 334: 1287–91.
  • 19
    Tugwell P, Pincus T, Yocum D, Stein M, Gluck O, Kraag G, et al, and The Methotrexate-Cyclosporine Combination Study Group. Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthritis. N Engl J Med 1995; 333: 137–41.
  • 20
    Klareskog L, van der Heijde D, de Jager JP, Gough A, Kalden J, Malaise M, et al, and the TEMPO (Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes) study investigators. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 2004; 363: 675–81.
  • 21
    Lipsky PE, van der Heijde DM, StClair EW, Furst DE, Breedveld FC, Kalden JR, et al, and the Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. Infliximab and methotrexate in the treatment of rheumatoid arthritis. N Engl J Med 2000; 343: 1594–602.
  • 22
    Weinblatt ME, Kremer JM, Bankhurst AD, Bulpitt KJ, Fleischmann RM, Fox RI, et al. A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 1999; 340: 253–9.
  • 23
    Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, 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.
  • 24
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315–24.
    Direct Link:
  • 25
    Van der Heijde DM, van 't Hof M, van Riel PL, van de Putte LB. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 1993; 20: 579–81.
  • 26
    Van Gestel AM, Prevoo ML, van 't Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL. Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis: comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism criteria. Arthritis Rheum 1996; 39: 34–40.
    Direct Link:
  • 27
    Siegert CE, Vleming LJ, Vandenbroucke JP, Cats A. Measurement of disability in Dutch rheumatoid arthritis patients. Clin Rheumatol 1984; 3: 305–9.
  • 28
    Van der Heijde DM, van Riel PL, Gribnau FW, Nuver-Zwart IH, van de Putte LB. Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet 1989; 1: 1036–8.
  • 29
    Bland JM, Altman DG. Statistical methods for assessing agreement between 2 methods of clinical measurement. Lancet 1986; 1: 307–10.
  • 30
    Lassere M, Boers M, van der Heijde D, Boonen A, Edmonds J, Saudan A, et al. Smallest detectable difference in radiological progression. J Rheumatol 1999; 26: 731–9.
  • 31
    Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College of Rheumatology preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38: 727–35.
    Direct Link:
  • 32
    Prevoo ML, van Gestel AM, van 't Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL. Remission in a prospective study of patients with rheumatoid arthritis: American Rheumatism Association preliminary remission criteria in relation to the disease activity score. Br J Rheumatol 1996; 35: 1101–5.
  • 33
    Dougados M, Combe B, Cantagrel A, Goupille P, Olive P, Schattenkirchner M, et al. Combination therapy in early rheumatoid arthritis: a randomized, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components. Ann Rheum Dis 1999; 58: 220–5.
  • 34
    Haagsma CJ, van Riel PL, de Jong AJ, van de Putte LB. Combination of sulphasalazine and methotrexate versus the single components in early rheumatoid arthritis: a randomized, controlled, double-blind, 52 week clinical trial. Br J Rheumatol 1997; 36: 1082–8.
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