PMID- 15641055
OWN - NLM
STAT- MEDLINE
DCOM- 20050215
LR  - 20131121
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 52
IP  - 1
DP  - 2005 Jan
TI  - Early suppression of disease activity is essential for maintenance of work 
      capacity in patients with recent-onset rheumatoid arthritis: five-year experience 
      from the FIN-RACo trial.
PG  - 36-41
AB  - OBJECTIVE: To explore the impact of an early treatment response on maintenance of 
      work capacity in patients with early, active rheumatoid arthritis (RA). METHODS: 
      In the Finnish Rheumatoid Arthritis Combination Therapy trial, 195 patients with 
      recent-onset RA were randomized to receive either a combination of 
      disease-modifying antirheumatic drugs (DMARDs) with prednisolone or a single 
      DMARD with or without prednisolone for 2 years. Treatment responses were 
      evaluated according to the American College of Rheumatology (ACR) criteria. After 
      a 5-year followup, the cumulative number of days of sick leave and RA-related 
      permanent work disability was calculated for each of the 162 patients who were 
      available for the active work force at baseline. RESULTS: Of the 159 patients 
      assessed at 6 months, 29 were in clinical remission, 66 achieved an ACR50 
      response but not remission, 29 achieved an ACR20 response but not an ACR50 
      response, and 35 failed to achieve an ACR20 response. In these 4 groups, the 
      median numbers of work disability days per patient-year from 6 months through 60 
      months of followup were 0 (interquartile range [IQR] 0-3), 4 (IQR 0-131), 16 (IQR 
      0-170), and 352 (16-365), respectively (P < 0.001). Pairwise multiple comparisons 
      showed a statistically significant difference between all groups except the ACR50 
      and ACR20 groups. At 12 months, 30 patients were in remission. None of the 44 
      patients in remission at 6 or 12 months became permanently work disabled over the 
      5-year followup, as compared with 15 patients in the ACR50 group (23%), 6 in the 
      ACR20 group (21%), and 19 without an ACR20 response at 6 months (56%). 
      CONCLUSION: Prompt induction of remission translates into maintenance of work 
      capacity. At 6 months, an ACR50 response is no better than an ACR20 response with 
      regard to future productivity, while failure to achieve an ACR20 response carries 
      a high risk for work disability.
FAU - Puolakka, Kari
AU  - Puolakka K
AD  - Department of Medicine, Lappeenranta Central Hospital, Valto Kakelan katu 1, 
      Lappeenranta FIN-53130, Finland. kari.puolakka@fimnet.fi
FAU - Kautiainen, Hannu
AU  - Kautiainen H
FAU - Mottonen, Timo
AU  - Mottonen T
FAU - Hannonen, Pekka
AU  - Hannonen P
FAU - Korpela, Markku
AU  - Korpela M
FAU - Hakala, Markku
AU  - Hakala M
FAU - Jarvinen, Pentti
AU  - Jarvinen P
FAU - Ahonen, Jari
AU  - Ahonen J
FAU - Forsberg, Sinikka
AU  - Forsberg S
FAU - Leirisalo-Repo, Marjatta
AU  - Leirisalo-Repo M
CN  - FIN-RACo Trial Group
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antirheumatic Agents)
RN  - 3XC8GUZ6CB (Sulfasalazine)
RN  - 4QWG6N8QKH (Hydroxychloroquine)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adult
MH  - Anti-Inflammatory Agents/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy/*physiopathology
MH  - Disability Evaluation
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Hydroxychloroquine/therapeutic use
MH  - Male
MH  - Methotrexate/therapeutic use
MH  - Middle Aged
MH  - Prednisolone/*therapeutic use
MH  - Remission Induction
MH  - Sick Leave
MH  - Sulfasalazine/therapeutic use
MH  - Time Factors
MH  - *Work Capacity Evaluation
EDAT- 2005/01/11 09:00
MHDA- 2005/02/16 09:00
CRDT- 2005/01/11 09:00
PHST- 2005/01/11 09:00 [pubmed]
PHST- 2005/02/16 09:00 [medline]
PHST- 2005/01/11 09:00 [entrez]
AID - 10.1002/art.20716 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2005 Jan;52(1):36-41. doi: 10.1002/art.20716.