CLINICAL AND RADIOGRAPHIC OUTCOMES OF RHEUMATOID-ARTHRITIS PATIENTS NOT TREATED WITH DISEASE-MODIFYING-DRUGS

Objective. To compare the radiographic and clinical features of rheuma toid arthritis (RA) patients who were not given disease-modifying anti rheumatic drugs (DMARDs) with those of RA patients who were followed u p and treated,vith DMARDs at a rheumatology clinic. Methods. The popul ation of this case-control study includes a series of RA patients who immigrated to Israel from the previous Union of Soviet Socialist Repub lics and who were treated only with nonsteroidal antiinflammatory drug s. Control patients who were followed up and treated with DMARDs at ou r rheumatology clinic were matched by sex, disease duration, number of actively inflamed joints, and the presence of serum rheumatoid factor . The outcome measures were the number of deformed and radiographicall y damaged joints. Radiographic damage was evaluated by the methods of Steinbrocker and Sharp. Results. The study population consisted of 22 RA patients (15 women, 7 men) who were not treated with DMARDs and 22 patients (15 women, 7 men) who were treated with DMARDs. The mean dise ase duration was 16.2 years for the study patients and 14.3 years for the controls. Compared with the matched controls, RA patients who were not treated with DMARDs were found to have a significantly higher mea n number of deformed joints (13.8 versus 7,2), a higher mean number of damaged joints (24.4 versus 15.5), and a higher overall damage score by the Sharp criteria (146.1 versus 65.7). Conclusion, RA patients who were not given DMARDs had a 1.57-fold increased number of radiographi cally damaged joints and a 2.22-fold increased overall Sharp damage sc ore compared with patients who were treated with second-line agents.