Results of a recent study have shown that as compared to the standard 3-month outpatient treatment, putting rheumatoid arthritis patients on an intensive monthly outpatient treatment (with anti-rheumatic drugs and steroid injections) helps to significantly improve their symptoms.
During the study 111 patients suffering from rheumatoid arthritis were randomly placed in either the “intensive management” group or the “routine care” group. The intensive approach included monthly assessment of patients’ disease activity score (DAS) to guide treatment with oral antirheumatic drugs and steroid injections. ‘Routine care’ othe other hand included the standard 3-monthly assessment (without DAS calculation to guide treatment). The main aim of the study was to compare these 2 treatment approaches for their effectiveness.
After 18 months of the study the researchers calculated the percentage of patients in each group who were responding well to the treatment (‘good response’ to treatment was defined as a DAS < 2.4 and a fall in this score from baseline by >1.2 points). It was observed that in the intensive management group 82% of the patients showed a good response whereas only 44% of patients in the routine care group responded well.
The researchers also found that 65% of the patients receiving the intensive management showed a remission at the end of the study as compared to just 16% in the routine care group. Hence, the researchers concluded from the study that an intensive monthly outpatient treatment is more effective in improving symptoms of rheumatoid arthritis as compared to the standard 3-month outpatient treatment. Further, the intensive approach did not cost more than the standard treatment.
Although the results of this study have considerable implications for management of rheumatoid arthritis patients, more studies are required to find out whether this improvement can be associated with significant reduction in work disability, need for surgery or hospital care.