Objective. To study the impacts of 1) the delay from the onset of symptoms to the institution of diseasemodifying antirheumatic drug (DMARD) therapy, 2) two treatment strategies (treatment with a combination of DMARDs or with a single drug), and 3) the presence of HLA-DRB1 alleles (shared epitope) on the prediction of disease remission after 2 years in patients with early rheumatoid arthritis (RA).Methods. In the FIN-RACo (FINnish Rheumatoid Arthritis Combination therapy) trial, 195 patients with recent-onset RA (median duration 6 months) were randomly assigned to receive either 1) a combination of DMARDs (sulfasalazine, methotrexate, hydroxychloroquine, and prednisolone) or 2) a single DMARD with or without prednisolone. The presence of a shared epitope was tested for in 165 of the 178 patients completing the study. The additional variables of age, sex, presence of rheumatoid factor, number of fulfilled American College of Rheumatology criteria for the classification of RA, and length of delay from onset of symptoms to institution of therapy were entered into a logistic regression model to determine the significant predictors for remission at 2 years.Results. The delay to therapy (cut point of 4 months) was the only significant predictor for remission in patients treated using the single-DMARD strategy, while no variable was a significant predictor for remission in those treated using the combination-DMARD strategy. The frequency of achieving remission in the combination-DMARD group after 2 years was similar in patients with short (0-4 months) and long (>4 months) delay periods (11 of 26 patients and 22 of 53 patients, respectively [ϳ42% in each group]), while the corresponding frequencies in the single-DMARD group were 8 of 23 patients (35%) and 7 of 63 patients (11%) (P ‫؍‬ 0.021). The presence of a shared epitope was not related to the induction of remission.Conclusion. The delay of a few months from the onset of symptoms to institution of therapy decreases the ability of the traditional single-drug strategy to induce remission in early RA.

Objective-To obtain information on the incidence of rheumatoid arthritis and on its recent trends in Finland.

Most patients with early active RA achieve clinical remission and develop negligible joint damage with the intensified FIN-RACo regimen. Adding INFL for the first 6 months delays radiological progression.

Patients with psoriasis have an increased incidence of arthritis. Information on the incidence of psoriatic arthritis (PsA) is sparse. The present study covered those subjects who were entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for PsA in 5/21 central hospital districts in Finland (population basis ~ 1 million adults) in 1990. A total of 65 incident cases satisfied the concept of PsA. The annual incidence of PsA was 6/100 000 of the adult population (^ 16 yr of age). The mean age at diagnosis was 46.8 yr. The peak incidence occurred in the 45-54 yr age group. The male to female ratio was 1.3:1. The incidence rate in the present study is in agreement with the sparse former figures, but age-specific incidence figures which have not been published earlier are also presented.

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