Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study) - A randomized, controlled trial
Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study) - A randomized, controlled trial
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DOI：
10.1002/art.21405
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发表时间：
2005-11-01
影响因子：
--
通讯作者：
Dijkmans, C
中科院分区：
文献类型：
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作者：
Goekoop-Ruiterman, YPM;de Vries-Bouwstra, JK;Dijkmans, C
目标。几种治疗策略在改善类风湿性关节炎(RA)方面已被证明是有价值的，但预防长期关节损伤和功能衰退的最佳策略尚不清楚。我们进行了这项研究，以比较4种不同治疗策略的临床和放射学结果，并对所有患者进行密切监测。在一项多中心随机临床试验中，508名患者被分配到4种治疗策略中的一种：序贯抗风湿药物单一治疗(组1)、递增联合治疗(组2)、逐渐减少大剂量泼尼松的初始联合治疗(组3)和肿瘤坏死因子拮抗剂英夫利昔单抗的初始联合治疗(组4)。每3个月进行一次治疗调整，以努力获得较低的疾病活动度(44个关节的疾病活动度评分
Objective. Several treatment strategies have proven value in the amelioration of rheumatoid arthritis (RA), but the optimal strategy for preventing long-term joint damage and functional decline is unclear. We undertook this study to compare clinical and radiographic outcomes of 4 different treatment strategies, with intense monitoring in all patients.Methods. In a multicenter, randomized clinical trial, 508 patients were allocated to 1 of 4 treatment strategies: sequential disease-modifying antirheumatic drug monotherapy (group 1), step-up combination therapy (group 2), initial combination therapy with tapered high-dose prednisone (group 3), and initial combination therapy with the tumor necrosis factor antagonist infliximab (group 4). Treatment adjustments were made every 3 months in an effort to obtain low disease activity (a Disease Activity Score in 44 joints of