In a nutshell
The authors aimed to evaluate how sustained remission affects joint inflammation in rheumatoid arthritis.
Some background
Following successful treatment, RA patients often enter a state called “clinical remission” i.e. the disease activity has decreased. Patients are said to be in clinical remission if they have less morning stiffness (<15 minutes), no swollen or tender joints, and reduction of certain blood characteristics associated with RA. However, despite relief from painful joints, underlying (non-noticeable) joint swelling is often still present. This can only be detected by imaging techniques such as Magnetic Resonance Imaging (MRI) and x-ray.
Methods & findings
This study involved 118 early RA patients (average age 51) with arthritis of the wrist. Most patients had the disease for less than 1 year. For two years, patients were treated with a combination of two drugs: methotrexate (Trexal) and etanercept (Enbrel), or a combination of three drugs: methotrexate, sulfasalazine (Azulfidine, Salazopyrin) and hydroxychloroquine (Plaquenil).
All patients had an MRI scan to see if they still had joint inflammation after treatment.
The study found that all 118 patients still had underlying joint inflammation, after two years of drug treatment. This was present even in those patients who were in “clinical remission”.
The bottom line
The authors conclude that it is risky to stop treatment for RA even after painful symptoms have gone away as inflammation may still be present.
The fine print
It is not known what the long term effects of this underlying inflammation may be.
Published By :
Arthritis Care & Research
Date :
Jan 07, 2015
