OUTCOME OF 2ND LINE THERAPY IN RHEUMATOID-ARTHRITIS

Objectives-To study the outcome in patients with arthritis (RA) who to lerate second line drug therapy for five years. Methods-We enrolled in to prospective controlled trials, 190 patients with rheumatoid arthrit is who tolerated 'disease modifying' antirheumatic drug therapy for fi ve years. Demographic data were recorded. Disease activity was measure d every six months for two years and annually thereafter, using clinic al and laboratory variables. Patient function was measured using the m odified Health Assessment Questionnaire. The change in each variable w as analysed using paired Wilcoxon tests. Results-Patient function impr oved significantly compared with baseline. The improvement was maximal after one to two years, and thereafter function started to decline sl owly. After five years of treatment the patients' function was still s ignificantly better than before treatment had started. There were high ly significant improvements in all variables measured to assess diseas e activity, which remained well controlled throughout the five year pe riod. Conclusion-Good control of disease activity and improved functio n can be achieved long term in approximately 30% of RA patients treate d with injectable gold, sulphasalazine or penicillamine.