NEW YORK, Mar 08 (Reuters Health) -- Early treatment for rheumatoid
arthritis using drugs that are usually held in reserve can help patients avoid
some of the pain and physical disabilities that accompany the disease,
researchers report.
Such treatments, often called "second-line" treatments, for rheumatoid
arthritis include gold salt injections, antimalarial drugs and immunosuppressive
drugs.
In the past, doctors treated the disease with bed rest. Aggressive drug
treatment was generally delayed due to side effects that can range from itchy
skin to kidney disease.
However, recent research suggests that putting off treatment with these
drugs can lead to more pain, physical disability and premature death over the
long term.
Indeed, the current study in The Journal of Rheumatology found that "a delay
in instituting therapy with second-line agents... has significant effects on
long-term patient outcome and provides strong evidence in support of early
therapy in rheumatoid arthritis."
The investigators followed 119 patients who participated in a 9-month study
comparing the drug hydroxychlorquine sulfate (HCQ) with (an inactive) placebo.
Patients receiving HCQ were in the early treatment group and patients who
received the placebo were part of the delayed treatment group. After 3 years,
patients whose treatment was delayed experienced more pain and physical
disabilities, results show. Therefore, delaying treatment with second-line
agents "can lead to disease activity that may be more difficult to bring under
control than would have been the case had treatment been started earlier,"
conclude Eva Tsakonas of McGill University in Montreal, Canada, and colleagues.
"This results in pain, physical disability, and a lack of well being that is
more prolonged than might have been expected," they add.
