Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Evidence for early disease-modifying drugs in rheumatoid arthritis. | Available online http content 6 1 15 Commentary Evidence for early disease-modifying drugs in rheumatoid arthritis David L Scott Department of Rheumatology Kings College Hospital London UK Corresponding author David L Scott e-mail Received 6 Oct 2003 Accepted 6 Nov 2003 Published 16 Dec 2003 Arthritis Res Ther 2004 6 15-18 DOI ar1030 2004 BioMed Central Ltd Print ISSN 1478-6354 Online ISSN 1478-6362 Abstract Some research evidence supports early aggressive treatment of rheumatoid arthritis RA using combination therapy with two or more disease modifying anti-rheumatic drugs DMARDs plus steroids or even DMARDs plus an anti-TNF. By contrast conservatively delayed DMARD monotherapy given after non-steroidal anti-inflammatory drugs have failed has been criticised. However recent long-term studies highlight the complexities in evaluating whether to abandon pyramidal treatment in favour of early DMARDs. Although patients given early DMARD therapy show short-term benefits longer-term results show no prolonged clinical advantages from early DMARDs. By 5 years patients receiving early DMARDs had similar disease activity and comparable health assessment questionnaire scores to patients who received DMARDs later in their disease course. X-ray progression was persistent and virtually identical in both groups. These negative findings do not invalidate the case for early DMARD therapy as it is gives sustained reductions in disease activity in the early years of treatment without excessive risks from adverse effects. However early DMARDs alone do not adequately control RA in the longer term. This may require starting with very aggressive therapy or treating patients more aggressively after early DMARD therapy has been initiated. Introduction The optimal treatment for early rheumatoid arthritis RA remains the subject of intense debate. There are many options. There is some support for aggressive treatment by immediately .
