Loss of functional capacity caused by a delayed onset of DMARD therapy in rheumatoid arthritis. Long-term follow-up results of the Keitel function test - Brief definite report

The aim of this analysis to investigate the impact of the postponement of D MARD therapy on the functional outcome of rheumatoid arthritis after 10 yea rs of disease. 321 individuals with a disease duration of at least ten year s were selected out of a cohort of more than 1800 patients. Two groups were analysed separately: patients who started DMARD therapy within the first y ear of their disease, and patients who received their first DMARD not earli er than five years after the onset of RA. The Keitel functional index was d etermined in every patient after 10 years of RA. After 10 years of disease, the swollen joint count and the ESR had decreased in both groups to a comp arable degree. However, patients with early treatment performed significant ly better in the Keitel test compared to the group with delayed therapy. Al though patients with seropositive RA or rheumatoid nodules had a worse outc ome in general, the benefit of early treatment was also significant in thes e subgroups.