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Earlier and more intense treatment of rheumatoid arthritis (RA) may be a key factor in the discovery that instances of the disease today are milder than they have been in the past. Researchers have noticed a trend toward patients presenting with RA earlier in the disease, seeking treatment sooner, and receiving more thorough treatment today than in the previous 2 decades. As a result, the number of patients whose RA goes on to extreme cases has dropped sharply.
"Patients with early RA presenting in recent years have less severe disease activity at presentation, as well as a more favorable course of their disease, compared with patients in earlier years," lead researcher Paco M.J. Welsing, MD, said.
Investigators in the Netherlands studied a total of 525 newly diagnosed RA patients over 20 years, from 1985 to 2005. The report, published in the September 2005 issue of Arthritis & Rheumatism, stated that the duration of symptoms for patients had decreased from an average of 309 days in 1985 to 212 days in 2005. Initial improvement of symptoms with treatment also was greater in more recently diagnosed patients. The researchers speculate that this finding could be the result of more aggressive treatment, as well as more patients being referred to a rheumatologist after initial diagnosis, a strategy not normally followed in the past.