Skip to main content

Advertisement

SpringerLink
Log in

Role of DMARD Naïve Period in the Development of Severe Rheumatoid Arthritis

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Rheumatoid arthritis (RA) is a symmetric poly-arthritis predominantly affecting the small synovial joints, although any synovial joint can be involved. The underlying cause is not known; however, predilection for the disease is impacted by genetic and environmental factors. Several factors predict disease severity in RA including development of erosions, female sex and duration of disease. This study evaluates the role of disease duration, early initiation of disease modifying anti-rheumatic drugs (DMARDs) and auto-antibodies like rheumatoid factor in predicting erosive disease in Indian patients with rheumatoid arthritis.

Methods

A 2-year hospital-based cross-sectional observational study was conducted in the Department of Medicine in a tertiary care centre in Kumaon region of Uttarakhand in northern India. 260 patients diagnosed with RA on the basis of 2010 ACR/EULAR criteria were included.

Results

A total of 135 patients had erosive disease, with DMARD naive median period of 3 years compared to 125 patients with non-erosive disease, with DMARD naive median period of 2 years. On the basis of this data and after evaluation for radiographic erosions, it was found that a longer DMARD naive period predicts higher odds of developing erosive disease.

Conclusion

Early diagnosis of rheumatoid arthritis and initiation of DMARDs is crucial in increasing quality of life and preventing severe disease with deformities, erosive changes and extra-articular manifestations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Handa, R., Rao, U. R. K., Lewis, J. F. M., Rambhad, G., Shiff, S., & Ghia, G. J. (2016). Literature review of rheumatoid arthritis in India. International Journal of Rheumatic Diseases,19, 440–451.

    Article  Google Scholar 

  2. Malaviya, A. N., Kapoor, S. K., Singh, R. R., Kumar, A., & Pande, I. (1993). Prevalence of rheumatoid arthritis in the adult Indian population. Rheumatology International,13, 131–134.

    Article  CAS  Google Scholar 

  3. Pincus, T., Callahan, L. F., Sale, W. G., Brooks, A. L., Payne, L. E., & Vaughn, W. K. (1984). Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis and Rheumatology,27, 864–872.

    Article  CAS  Google Scholar 

  4. Lard, L. R., Visser, H., Speyer, I., van der Horst-Bruinsma, I. E., Zwinderman, A. H., Breedveld, F. C., et al. (2001). Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of 2 cohorts who received different treatment strategies. American Journal of Medicine,111, 446–451.

    Article  CAS  Google Scholar 

  5. Van Zeben, D., Hazes, J. M., Zwinderman, A. H., Vandenbroucke, J. P., & Breedveld, F. C. (1993). Factors predicting outcome of rheumatoid arthritis, results of a follow up study. Journal of Rheumatology,20, 1288–1296.

    PubMed  Google Scholar 

  6. Aletaha, D., Neogi, T., Silman, A. J., et al. (2010). 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Annals of the Rheumatic Diseases,62(9), 1580–1588.

    Article  Google Scholar 

  7. Singer, J. M., & Plotz, C. M. (1956). The latex fixation test. I. Application to the serologic diagnosis of rheumatoid arthritis. The American Journal of Medicine,21, 888–892.

    Article  Google Scholar 

  8. Shankar, S., Grover, R., & Handa, R. (2006). Role of anti cyclic citrullinated peptide antibodies in erosive disease in patients with rheumatoid arthritis. Indian Journal of Medical Research,124, 689–696.

    CAS  PubMed  Google Scholar 

  9. Shankar, S., Handa, R., Aneja, R., Marwaha, V., Ammini, A. C., & Aprajita, V. (2009). Bone mineral density in Indian women with rheumatoid arthritis. Rheumatology International,29, 377–381.

    Article  Google Scholar 

  10. Jacoby, R. K., Jayson, M. I. V., & Cosh, A. (1973). Onset, early stages and prognosis of RA: Clinical study of 100 patients with 11-year follow-up. The BMJ,ii, 96.

    Article  Google Scholar 

  11. Penserga, E. G., Natividad, T. A. L., & Salido, E. S. (2015). Clinical profile of 266 Filipino patients with rheumatoid arthritis included in the rheumatoid arthritis database and registry (RADAR) of the Philippine General Hospital. International Journal of Rheumatic Diseases,18, 433–438. https://doi.org/10.1111/1756-185X.12273.

    Article  CAS  PubMed  Google Scholar 

  12. Zaman, T., Agarwal, S., & Handa, R. (2007). Complementary and alternative medicine use in rheumatoid arthritis: an audit of patients visiting a tertiary care centre. National Medical Journal of India,20(5), 236–239.

    PubMed  Google Scholar 

  13. Demoruelle, M. K., & Deane, K. D. (2012). Treatment strategies in early rheumatoid arthritis and prevention of rheumatoid arthritis. Current Rheumatology Reports,14(5), 472–480.

    Article  CAS  Google Scholar 

  14. Nell, V. P., Machold, K. P., Eberl, G., Stamm, T. A., Uffmann, M., & Smolen, J. S. (2004). Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology (Oxford),43(7), 906–914.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Government Medical College, Haldwani, Uttarakhand, 263139, India

    Madhav Bahadur, Paramjeet Singh, Vivekanand Satyawali & Arun Joshi

Authors
  1. Madhav Bahadur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paramjeet Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vivekanand Satyawali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arun Joshi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Madhav Bahadur.

Ethics declarations

Conflict of interest

Madhav Bahadur, Paramjeet Singh, Vivekanand Satyawali and Arun Joshi declare that they have no conflicts of interest.

Ethical Standard Statement

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed Consent

For this type of study informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bahadur, M., Singh, P., Satyawali, V. et al. Role of DMARD Naïve Period in the Development of Severe Rheumatoid Arthritis. JOIO 54, 513–517 (2020). https://doi.org/10.1007/s43465-020-00077-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-020-00077-8

Keywords

Search

Navigation