Patients with rheumatoid arthritis benefit from early 2nd line therapy: 5 year followup of a prospective double blind placebo controlled study

J Rheumatol. 1995 Dec;22(12):2208-13.


Objective: To compare 2 treatment strategies in a prospective 5 year study of patients with rheumatoid arthritis (RA): early treatment with slow acting antirheumatic drugs (SAARD) versus a "wait and see" attitude.

Methods: One hundred thirty-seven patients with RA of < 2 years' duration entered a double blind placebo controlled study: patients in the "early" (E) group were treated with auranofin within one year of diagnosis of RA, and SAARD treatment in the initially placebo treated group was delayed 8 months compared with the former group. [The results after 2 years clearly favored early treatment (Borg G, Allander E, Lund B, et al: J Rheumatol 1988; 15:1747-54)].

Results: After a total observation period of 5 years in 75 representative patients, continued improvement in the E group was demonstrated, and differences between the 2 groups were maintained with regard to clinical variables, outcome measures, and radiographic evaluation.

Conclusion: The results indicate the existence of a therapeutic window in RA within the first 2 years of the disease.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Antirheumatic Agents / administration & dosage*
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / physiopathology
  • Auranofin / administration & dosage*
  • Disability Evaluation
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Hand Strength / physiology
  • Humans
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Pathology, Clinical
  • Prospective Studies
  • Radiography
  • Treatment Outcome


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Auranofin