The BeSt Way to Treat Early Rheumatoid Arthritis?
Authors: James R. O'Dell
Journal: Annals of Internal Medicine (2007)

Editorials20 March 2007The BeSt Way to Treat Early Rheumatoid Arthritis?James R. O'Dell, MDJames R. O'Dell, MDFrom University of Nebraska Medical Center, Omaha, NE 68198.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-6-200703200-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Over the past few years, the outlook for patients who are newly diagnosed with rheumatoid arthritis (RA) has improved dramatically (1) because of several key advances, including early use of disease-modifying, antirheumatic drugs (DMARDs); the use of DMARDs in combination; use of biologicals, especially antitumor necrosis factor-α agents; and recognition of the critical role of inflammation in the vascular complications that lead directly to death. Patients who are diagnosed with RA today are much less likely to become disabled, require joint replacement (2), or die of premature atherosclerotic disease, which is associated with RA-related systemic inflammation.Despite these advances, many ...References1. O'Dell JR. Therapeutic strategies for rheumatoid arthritis. N Engl J Med. 2004;350:2591-602. [PMID: 15201416] CrossrefMedlineGoogle Scholar2. Pincus T, Sokka T, Kautiainen H. Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985. Arthritis Rheum. 2005;52:1009-19. [PMID: 15818706] CrossrefMedlineGoogle Scholar3. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Comparison of treatment strategies in early rheumatoid arthritis. A randomized, trial. Ann Intern Med. 2007;146:406-15. LinkGoogle Scholar4. O'Dell JR, Haire CE, Erikson N, Drymalski W, Palmer W, Eckhoff PJ, et al. 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Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum. 2005;52:3381-90. [PMID: 16258899] CrossrefMedlineGoogle Scholar17. Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet. 2004;364:263-9. [PMID: 15262104] CrossrefMedlineGoogle Scholar18. Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum. 1995;38:727-35. [PMID: 7779114] CrossrefMedlineGoogle Scholar19. van der Heijde DM, van ‘t Hof M, van Riel PL, van de Putte LB. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol. 1993;20:579-81. [PMID: 8478878] MedlineGoogle Scholar20. Pincus T, Sokka T, Kavanaugh A. Relative versus absolute goals of therapies for RA: ACR 20 or ACR 50 responses versus target values for “near remission” of DAS or single measures. Clin Exp Rheumatol. 2004;22:S50-6. [PMID: 15552515] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Nebraska Medical Center, Omaha, NE 68198.Disclosures: None disclosed.Corresponding Author: James R. O'Dell, MD, Department of Internal Medicine, University of Nebraska Medical Center, 983025 Nebraska Medical Center, Omaha, NE 68198-3025. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of Treatment Strategies in Early Rheumatoid Arthritis Yvonne P.M. Goekoop-Ruiterman , Jeska K. de Vries-Bouwstra , Cornelia F. Allaart , Derkjen van Zeben , Pit J.S.M. Kerstens , J. Mieke W. Hazes , Aelko H. Zwinderman , André J. Peeters , Johanna M. de Jonge-Bok , Constant Mallée , Wim M. de Beus , Peter B.J. de Sonnaville , Jacques A.P.M. Ewals , Ferdinand C. Breedveld , and Ben A.C. Dijkmans Metrics Cited byTraitement actuel de la polyarthrite rhumatoïdeReevaluation of the Role of Duration of Morning Stiffness in the Assessment of Rheumatoid Arthritis ActivityAre we ready for top-down therapy for inflammatory bowel diseases: conTreatment Strategies for Early Rheumatoid Arthritis 20 March 2007Volume 146, Issue 6Page: 459-460KeywordsClinical trialsDrug regulationDrug therapyDrugsInflammationMethotrexatePatientsQuality of lifeRheumatoid arthritis ePublished: 20 March 2007 Issue Published: 20 March 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...