Rheumatoid nodules do not predict response to treatment with slow-acting anti-rheumatic drugs |
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Authors: | Dr. G. M. Hall A. Studnicke E. C. Huskisson D. L. Scott |
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Affiliation: | (1) Department of Rheumatology, St Bartholomew's and Homerton Hospital, EC1A 7BE London, UK |
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Abstract: | Summary Rheumatoid nodules have been associated with a poor long-term prognosis. We investigated whether they predict a poor response to treatment with slow-acting anti-rheumatic drugs (SAARDs). Two hundred and twenty-eight patients with rheumatoid arthritis (RA) were treated for six months with a SAARD. Clinical and laboratory assessments of disease activity were made initially and after 6 months' treatment. Patients were divided into two groups according to the presence or absence of nodules at entry. Twenty-one % had nodules before treatment but their response was no different to patients without nodules (79%), both groups showing improvements in all variables. Males were more likely to develop nodules and had a relative risk of 1.7. High titres of rheumatoid factor correlated with nodules and no sero-negative patients had nodules. We conclude that nodules are not predictive of poor response to treatment with a SAARD, despite their presence being associated with a poor long-term prognosis. One possible implication is that SAARDs themselves, despite an early response, may not effect long-term outcome. |
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Keywords: | Rheumatoid Arthritis Rheumatoid Nodules Slow-Acting Anti-Rheumatic Drugs |
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