Severe functional declines, work disability, and increased mortality in seventy‐five rheumatoid arthritis patients studied over nine years

Abstract

Seventy-five patients with rheumatoid arthritis (RA) were reviewed 9 years after an extensive evaluation which included quantitative measures of functional capacity. These patients had received multiple intraarticular injections of thiotepa with corticosteroids early in their course, but appear demographically and functionally similar to other RA patients who had not received this therapy. Severe morbidity was seen over the 9-year period in the 55 surviving patients, including significantly lower overall functional capacity in 92% of patients studied, lower grip strength in 93%, and longer button test results in 84%. Work disability occurred in 85% of patients under age 65

Development and assessment of indicators of rheumatoid arthritis severity: Results of a Delphi panel

“…It is associated with substantial morbidity and mortality (2,3). Because many of the adverse events associated with RA, such as opportunistic infections and cancer, are relatively rare and because all of them are potentially related to medication use, the study of RA-related comorbidities requires large numbers of patients with detailed information about medication use.…”

Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis: A two‐year prospective study (the DAMAGE study cohort)

“…However, joint damage accumulation is highly variable, differing up to 10-fold between individuals after 8-12 years of disease (3,4). The mechanisms that produce these widely varying results are as yet poorly defined in humans.…”

Decreases in rates of hospitalizations for manifestations of severe rheumatoid arthritis, 1983–2001

“…This change in treatment philosophy was not based on direct comparisons of the efficacy of these strategies, but rather was motivated by the recognition that joint damage occurs early in RA, that the health outcomes of patients treated using the previous strategy were generally poor, and that diseasemodifying medications were safer than previously thought (5)(6)(7)(8)(9)(10). Recently, the findings from several short-term controlled trials and observational studies have suggested that treatment with disease-modifying medications initiated early in the course of RA leads to improved control of joint inflammation, less joint damage, and better health compared with the outcomes following even short delays in treatment (11)(12)(13)(14)(15)(16)(17)(18).…”