September 6, 2005

Rheumatoid Arthritis May Be Becoming Milder

NEW YORK -- If anything good can be said about having rheumatoid arthritis, it may be that the condition is likely to be less severe than your mother's arthritis.

The disease has become milder over the past two decades, researchers report.

"These results seem to underline that the earlier referral of patients and earlier and more intense treatment of rheumatoid arthritis, as is currently advocated, seems to have an effect on outcome for patients," Dr. Paco M. J. Welsing told Reuters Health.

Welsing, at Radboud University Nijmegen Medical Center, in the Netherlands, and colleagues investigated disease activity and disability of all newly diagnosed rheumatoid arthritis patients seen in their clinic from 1985 to 2005. A total of 525 subjects were included in the analysis.

Patients seem to be seeking treatment earlier in the course of the disease, the authors report in the medical journal Arthritis & Rheumatism, with the duration of their symptoms having decreased from an average of 309 days two decades ago to 212 days in 2005.

All components of a disease activity scale (except well-being) improved over the interval studied, the results indicate, both when the patients were first seen and 5 years after their diagnosis.

Initial improvement in disease symptoms with treatment was also greater among more recently diagnosed patients, the researchers note, perhaps because the treatment strategy was more aggressive in more recent patients.

"In our opinion there can be two reasons for the less severe disease activity at presentation in the more recent subpopulation of our study," Welsing commented. "First, patients could come to a rheumatologist earlier after the onset of complaints. Further, it could be that patients with less severe complaints were in the past not referred to a rheumatologist and nowadays are referred to a rheumatologist."

"We cannot be certain that these two phenomena fully explain the decrease in disease activity at presentation," Welsing said. His group is planning to study trends over time in the longer-term outcomes of rheumatoid arthritis.

SOURCE: Arthritis & Rheumatism, September 2005.