Rheumatoid arthritis: is there any benefit to intensifying treatment in patients with low disease activity?

This study investigated if intensifying treatment during low disease activity was beneficial in patients with rheumatoid arthritis (RA). They found that patients with low disease activity do not benefit from treatment intensification.

Management of rheumatoid arthritis (RA) involves treating patients with disease-modifying anti-rheumatic drugs (DMARDs). Patients are monitored and treatment is adjusted to improve disease symptoms until remission (no symptoms).

RA severity is measured using a disease activity score (DAS). Low disease activity (LDA) is when patients have symptoms but there is reasonable function and slowed joint degeneration. There is no evidence that intensifying treatment in LDA further improves symptoms.

This study investigated if intensifying treatment in arthritis patients with low disease activity offers clinical benefit.

This study included data from patients with recent onset RA and undifferentiated (non-specific) arthritis. Patients were treated with a combination of medications including methotrexate (Trexall) and prednisone (Deltasone). DAS and health assessment questionnaire (HAQ) were analyzed.

69% patients had improved arthritis as measured by HAQ. 26% to 73% of patients achieved LDA. DAS and HAQ results indicate that LDA patients did not benefit from treatment intensification.

This study concluded that patients with low disease activity do not benefit from treatment intensification.

All medication regimes were grouped together and analyzed as treatment intensification. Certain medications may be more or less effective to achieve remission in patients with LDA.

If you have any concerns regarding arthritis treatment strategies, please discuss with your physician.