Early identification of rheumatoid arthritis

Author(s):
Nies, Jessica Annemarie Bernadette van
Published
2016
Publication type
Doctoral Thesis

Abstract

The first part is focused on early recognition of Rheumatoid Arthritis (RA). Two large early arthritis recognition clinics were started in Leiden and Groningen. The results showed that this initiative reduces the GP-delay significantly. Secondly, it was investigated whether an association between shorter symptom duration and a beneficial outcome in RA exists. Furthermore, it was questioned whether there was a confined period in which the start of DMARD therapy has a more beneficial effect. In the third part of the thesis certain disease features/ symptoms were investigated in more detail to assess if they had a prognostic or diagnostic value in arthralgia, early arthritis or RA patients. Finally, in the last part focused on mortality in RA. It was observed that patients that were treated early and with aggressive DMARD therapy had no increased mortality compared to the Dutch general population. In conclusion, the current thesis showed that lots of progress was made in the attempt to recognize rheumatoid arthritis earlier, that a therapeutic window of opportunity exits and that with prompt initiation of adequate DMARD-treatment RA should no longer be tagged as a chronic condition but that drug-free remission and improved survival are both achievable goals.

SurvivalWindow of opportunityEarly arthritisArtralgiaRheumatoid arthritis
Defense date
2016-03-03
Language
English
Supervisor(s)
Huizinga, T.W.J.; Helm-van Mil, A.H.M. van der
Qualification
Ph.D.
Degree granting institution
Department of Rheumatology, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University, Leiden
hdl
1887/38506
ISBN(s)
9789402800401

Funding

Sponsorship
The printing of this thesis was financially supported by Lamepro B.V., Abbvie B.V., Pfizer B.V., Sanofi B.V., UCB Pharma B.V. and Chipsoft B.V., which is gratefully acknowledged.