Consilium Medicum (Nov 2023)
The role of timely rheumatoid arthritis treatment effectiveness control
Abstract
Background. Regular assessment of rheumatoid arthritis (RA) activity is a key factor in therapy effectiveness improving. Aim. To prove that timely RA treatment control recommended by modern guidelines improves outcomes and reduce disability in real clinical practice. Materials and methods. Fourty patients with RA hospitalized at the University Clinical Hospital from January 2021 to January 2023 were included into a retrospective single-center study and divided into 2 groups. In the first group, RA activity was monitored after 3, 6, and 12 months, with therapy adjusted if necessary. In the second group, monitoring of RA activity was carried out after 12 months. The patients underwent clinical, laboratory and instrumental examinations (Tender Joint Count (TJC) and Swollen Joint Count (SJC), common blood test with differential white blood cell count, ESR, biochemical blood test, CRP, RF, ACCP, hands, feet and chest X-ray, ECG). RA activity was assessed using DAS28, CDAI, SDAI indices in both groups. Results. RA activity control after 12 months in patients of the first group regularly observed by a rheumatologist was better than in patients of the second group, who visited rheumatologist again only in 12 months. DAS28 decreased significantly, from 4.71±0.80 to 3.08±0.70 in the group with regular monitoring during the observation period. Remission or low activity was achieved by 75% of patients (5% remission and 70% low activity). Less dynamics was registered in patients of the second group: the initial DAS28 was 4.50±0.74, DAS28 after 12 months was 4.36±0.64, which corresponds to moderate activity. Low activity was achieved in 15% of patients, remission was not achieved in any patient. Conclusion. Strict adherence to the recommended terms for disease activity monitoring is necessary for successful RA treatment in real clinical practice.
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