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Cited by 1,460

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): A randomized, controlled trial

Open access
Goekoop‐Ruiterman, Y. P. M., De Vries‐Bouwstra, J. K., Allaart, C. F., Van Zeben, D., Kerstens, P. J. S. M., Hazes, J. M. W., Zwinderman, A. H., Ronday, H. K., Han, K. H., Westedt, M. L., Gerards, A. H., Van Groenendael, J. H. L. M., Lems, W. F., Van Krugten, M. V., Breedveld, F. C., Dijkmans, B. A. C.·2005·Arthritis & Rheumatism

Abstract

Objective: Several treatment strategies have proven value in the amelioration of rheumatoid arthritis (RA), but the optimal strategy for preventing long‐term joint damage and functional decline is unclear. We undertook this study to compare clinical and radiographic outcomes of 4 different treatment strategies, with intense monitoring in all patients. Methods: In a multicenter, randomized clinical trial, 508 patients were allocated to 1 of 4 treatment strategies: sequential disease‐modifying antirheumatic drug monotherapy (group 1), step‐up combination therapy (group 2), initial combination therapy with tapered high‐dose prednisone (group 3), and initial combination therapy with the tumor necrosis factor antagonist infliximab (group 4). Treatment adjustments were made every 3 months in an effort to obtain low disease activity (a Disease Activity Score in 44 joints of ≤2.4). Results: Initial combination therapy including either prednisone (group 3) or infliximab (group 4) resulted in earlier functional improvement than did sequential monotherapy (group 1) and step‐up combination therapy (group 2), with mean scores at 3 months on the Dutch version of the Health Assessment Questionnaire (D‐HAQ) of 1.0 in groups 1 and 2 and 0.6 in groups 3 and 4 (P < 0.001). After 1 year, mean D‐HAQ scores were 0.7 in groups 1 and 2 and 0.5 in groups 3 and 4 (P = 0.009). The median increases in total Sharp/Van der Heijde radiographic joint score were 2.0, 2.5, 1.0, and 0.5 in groups 1–4, respectively (P < 0.001). There were no significant differences in the number of adverse events and withdrawals between the groups. Conclusion: In patients with early RA, initial combination therapy including either prednisone or infliximab resulted in earlier functional improvement and less radiographic damage after 1 year than did sequential monotherapy or step‐up combination therapy.

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Crossref · 10.1002/art.21405

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Authors
Goekoop‐Ruiterman, Y. P. M., De Vries‐Bouwstra, J. K., Allaart, C. F., Van Zeben, D., Kerstens, P. J. S. M., Hazes, J. M. W., Zwinderman, A. H., Ronday, H. K., Han, K. H., Westedt, M. L., Gerards, A. H., Van Groenendael, J. H. L. M., Lems, W. F., Van Krugten, M. V., Breedveld, F. C., & Dijkmans, B. A. C.
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2005-10-28
Volume
52
Issue
11
Pages
3381-3390
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
OpenAlex
W2156996668
Cited by
1,460
References
1
FWCI
52.39
Type
journal article
Language
en
Open access
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