류마티스관절염에서 치료 시기가 질병 활성도 및 관절 손상에 미치는 영향 = The Effect of Early Diagnosis and Treatment on the Disease Activity and Joint Damages in Korean Patients with Rheumatoid Arthritis

다국어 초록 (Multilingual Abstract)

Objective: We investigated the effect of the early diagnosis and treatment on the disease activity and joint damage in patients with rheumatoid arthritis (RA). Methods: We enrolled 242 RA patients (male 50 patients, female 192 patients, mean age 49.7±13.5 years old) in this study. They were divided into two groups according to lag-time to diagnose RA from the onset of symptoms. 136 RA patients whose lag-time did not exceed 12 months were classified into early diagnosed RA group and 106 RA patients whose lag-time over 12 months were classified into delayed diagnosed RA group. Baseline date were assessed at the time of diagnosis. Disease activity was assessed by sums of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) during first year after diagnosis. Radiological joint damages were evaluated using modified Sharp score. Results: At the time of diagnosis, the age of patients, ESR and platelet counts were significantly decreased, and hemoglobin level was significantly increased in early diagnosed RA group. Early diagnosed RA group showed lower sums of ESR and CRP than delayed diagnosed RA group significantly. Modified sharp score at the time of diagnosis and after treatment were significantly lower in early diagnosed RA group than delayed diagnosed RA group. The difference of modified sharp score between at the time of diagnosis and after treatment were lower in early diagnosed RA group than delayed diagnosed RA group too. Conclusion: The early diagnosis and treatment of RA reduced extent of joint damage and provoked better response to treatment significantly.

참고문헌 (Reference)

• 1 "류마티스관절염에서 혈청 C-반응성단백에 관한 연구" 27 : 271-5, 1984
• 2 "What is the natural history of rheumatoid arthritis" 19 : 123-51, 1993
• 3 "Very early treatment with infliximab in addition to methotrexate in early poor- prognosis rheumatoid arthritis reduces magnetic resonance imaging evidence of synovitis and damage with sustained benefit after infliximab withdrawal results from a twelve-month randomized, double-blind, placebo- controlled trial" 52 : 27-35, 2005
• 4 "The relationship between serial measures of disease activity and outcome in rheumatoid arthritis" 86 : 601-7, 1993
• 5 "The determination and measurement of functional disability in rheumatoid arthritis" 4 : 11-15, 2002
• 6 "The acute-phase response in relation to radiographic progression in early rheumatoid arthritis:a prospective study during the first three years of the disease" 32 : 9-13, 1993
• 7 "The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis" 31 : 315-24, 1988
• 8 "Prediction of erosiveness and rate of development of new erosions in early rheumatoid ar-thritis" 47 : 648-53, 1988
• 9 "Plain X-ray in rheumatoid arthritis:overview of scoring methods,their reliability and applicability" 10 : 435-453, 1996
• 10 "Outcome of rheumatoid arthritis in relation to age and rheumatoid factor at diagnosis" 20 : 45-52, 1993
• 11 "Long-term course and outcome of functional capacity in rheumatoid arthritis:the effect of disease activity and radiologic damage over time" 42 : 1854-1860, 1999
• 12 "Long- term outcome of treating rheumatoid arthritis:results after 20 years" 1 : 1108-11, 1987
• 13 "Laboratory testing in the rheumatic disease:a practical review" 98 : 185-191, 2005
• 14 "Joint erosions and patients with early rheumatoid arthritis" 34 : 74-78, 1995
• 15 "Hematologic abnormalities in rheumatoid arthritis" 1 : 195-219, 1972
• 16 "Haematological changes in rheumatoid disease" 3 : 433-65, 1977
• 17 "Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease" 16 : 585-91, 1989
• 18 "Early versus delayed treatment in patients with recent-onset rheumatoid arthritis:comparison of two cohorts who received different treatment strategies" 111 : 446-451, 2001
• 19 "Early referral recommendation for newly diagnosed rheumatoid arthritis:evidence based development of a clinical guide" 61 : 290-297, 2002
• 20 "Biannual radiographic assessments of hands and feet in a three- year prospective followup of patients with early rheumatoid arthritis" 35 : 26-34, 1992
• 21 "Auranofin improves outcome in early rheumatoid arthritis Results from a 2-year" 1747-54, jrheumatol1988
• 22 "Analysis of the synovial cell infiltrate in early rheumatoid synovial tissue in relation to local disease activity" 40 : 217-225, 1997