Leiden University Scholarly Publications

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Heimans, L. (2014)

Treatment of early rheumatoid and undifferentiated arthritis

Doctoral Thesis
This thesis focuses on different aspects of treatment of patients with rheumatoid arthritis (RA) and undifferentiated arthritis (UA), based on the results of three intervention studies; the IMPROVED-study, the BeSt study and the PROMPT study. This thesis discusses the results of different treatment strategies for patients with RA and UA; the percentage of patients that achieves remission , the mean disease activity, radiographic damage progression and daily functioning. I then analysed the factors that effect the response to treatment and the achievement of drug free remission . Then radiological damage progression is discussed. Are there patients with early arthritis who have rapid radiographic progression in the first year after diagnosis or we can prevent this with effective treatment? We also assessed whether patients with early RA have metacarpal bone mineral density loss after 4 months, measured with digital X-ray radiogrammetry, and whether this predicts radiological damage...Show moreThis thesis focuses on different aspects of treatment of patients with rheumatoid arthritis (RA) and undifferentiated arthritis (UA), based on the results of three intervention studies; the IMPROVED-study, the BeSt study and the PROMPT study. This thesis discusses the results of different treatment strategies for patients with RA and UA; the percentage of patients that achieves remission , the mean disease activity, radiographic damage progression and daily functioning. I then analysed the factors that effect the response to treatment and the achievement of drug free remission . Then radiological damage progression is discussed. Are there patients with early arthritis who have rapid radiographic progression in the first year after diagnosis or we can prevent this with effective treatment? We also assessed whether patients with early RA have metacarpal bone mineral density loss after 4 months, measured with digital X-ray radiogrammetry, and whether this predicts radiological damage progression after 1 year of anti-rheumatic treatment. Finally , I analyzed how the IMPROVED population was doing with regard to psychological well-being (mood and optimism), quality of life and the relationship of these so-called patient-reported outcomes with disease activity and achievement of remission.Show less
Functional ability
Methotrexate
Remission
Undifferentiated arthritis
Rheumatoid arthritis
All authors
Heimans, L.
Supervisor
Huizinga, T.W.J.
Co-supervisor
Allaart, C.F.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine (LUMC), Leiden University
Date
2014-05-13
ISBN (print)
9789461824295

Funding

Sponsorship
The research was financially supported by AbbVie, the Dutch Arthritis Foundation, the Netherlands Organisation for Scientific Research, the Dutch College for Health Insurances, Janssen Biologics B.V. and Schering-Plough B.V. The publication of this thesis was financially supported by the Dutch Arthritis Foundation (Reumafonds), AbbVie B.V., Pfizer B.V., Roche B.V. and UCB Pharma B.V.