INPATIENT TREATMENT FOR ACTIVE RHEUMATOID-ARTHRITIS - CLINICAL COURSEAND PREDICTORS OF IMPROVEMENT

The objective was to determine the clinical course and predictors of c linical response in patients with rheumatoid arthritis (RA) who are ho spitalized for active disease and functional deterioration. Sixty-thre e patients who were admitted to a rheumatology clinic for multidiscipl inary treatment were prospectively evaluated at 2-weekly intervals. Du ring the admission period, which lasted for a mean of 47 +/- 24 days, patients improved significantly according to variables of disease acti vity, functional status and emotional status. The change in the variab les appeared to be linear with time. Twenty-seven patients (43%) fulfi lled the Paulus 20% criteria for clinical response during treatment. A long disease duration, a high Larsen erosion score, a high level of d isease activity at admission and the institution of a disease-modifyin g anti-rheumatic drug within 3 months before admission were associated with a clinical response. In patients hospitalized for active disease , improvement appeared to be linear with time during admission. Patien ts with long-standing, destructive disease and a high level of disease activity improved most during hospitalization.