Disease-Modifying Drugs

Early treatment with disease-modifying antirheumatic drugs (DMARDs) can help rheumatoid arthritis (RA) patients achieve remission, a Swedish study has revealed.

In addition, these patients can experience sustained remission even after stopping the DMARDs if they were treated with them aggressively at the onset of the disease.

The study, titled “Disease-modifying antirheumatic drug-free sustained remission in rheumatoid arthritis: an increasingly achievable outcome with subsidence of disease symptoms,” concluded that patients who were treated with DMARDs instead of nonsteroidal anti-inflammatory drugs (NSAIDs) were able to reach disease remission without drugs even after the cessation of DMARDs.

The study authors did note, however, that some more aggressive or complicated cases of RA may not have the same response. These patients may need biologics or other drugs.

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Early Treatment is the Key

Overall, 155 patients out of the 1,007 in the study achieved DMARD-free sustained remission.

According to the study, published in Annals of the Rheumatic Diseases, the objective was to investigate whether “the sustained absence of synovitis after cessation of DMARD therapy, is a relevant long-term outcome of rheumatoid arthritis (RA) if (1) its occurrence is promoted by treatment and (2) this status reflects resolution of symptoms and disability.”

The authors of the study concluded that patients who were diagnosed and treated early with DMARDs tended to do better and were more able to reach remission or a reduction in symptoms.

Drug-Free Remission

The authors of the study wrote, “More intensive treatment strategies increased the chance for DMARD-free sustained remission, indicating that RA chronicity can be influenced. Patients with RA achieving DMARD-free sustained remission have a normalised functional status.”

“We know that patients who are diagnosed and treated within a three-month window do best – before their joints have been damaged by their disease – so this research confirms these earlier findings,” commented a spokesperson for Arthritis Research UK in a statement. “However, patients with very severe disease may find that DMARDs are not sufficiently effective and they need to go on to a biological therapy in order to get their RA under proper control.”

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Patient Grateful for Her Treatment

Betsy Lukinash, age 34, of Philadelphia, Pennsylvania, has had rheumatoid arthritis for three years.

She says she began with methotrexate — a DMARD — right off the bat and has not suffered the joint damage of some of her peers who didn’t start DMARD therapy early on. She also has not yet had to move on to biologics.

“I am very grateful to pretty much be in remission. Whether it is a drug-induced remission from my DMARD methotrexate or true disease remission, I am grateful,” she said. “I would not risk going off of my current medications,  but I am glad to not yet have to go on a biologic, nor do I have to rely on pain pills or steroids day-to-day.

Many (RA patients) are not so lucky to get a diagnosis and a treatment that works early on.
Betsy Lukinash, rheumatoid arthritis patient

She knows her successful treatment is not always the outcome for all RA patients.

“Many are not so lucky to get a diagnosis and a treatment that works early on,” she added.

Patients who are experiencing symptoms of rheumatoid arthritis should seek the help of a rheumatologist immediately.

Organizations like the Arthritis Foundation or the American College of Rheumatology can help patients find a rheumatologist or arthritis specialist in their area.

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