Lancet Rheumato: Effect of treatment within 6 weeks of rheumatic symptoms on prognosis

The first recommendation of the European Union against Rheumatology for early arthritis treatment is that patients should be treated by a professional rheumatologist within 6 weeks of the onset of symptomsRecently, the researchers examined the effects of long-term prognosis compared to the treatment of rheumatologists within 6 weeks of the ongoing symptoms compared to receiving professional treatment 7 to 12 weeks after the onsus of symptomsin the observational cohort study, in which patients with rheumatoid arthritis from France were involved in the study, who met the 1987 American Society of Rheumatology standards and were diagnosed with rheumatoid arthritis and provided data on the onset and remission of symptomsDepending on the time of the symptoms appearto to the first professional treatment, the patient was divided into 6 weeks, 7 weeks to 12 weeks and 12 weeksThe main results of the study were continued disease-free improved anti-rheumatic anti-rheumatic drugs (DMARD) remission and imaging progressionfrom 1 January 1996 to 31 December 2017, including a total of 1025 cases of rheumatoid arthritis and 514 cases of rheumatoid arthritis from 1 November 2002 to 30 April 2005The median follow-up time was 7.1 years and 10.0 years, respectivelyThe previous 1025 patients had 30 (24%), 45 (20%) and 100 (15%) after 7 years of follow-up, 6 weeks, 7 weeks to 12 weeks and 12 weeks of duration without DMARD remission in each group of 12 weeks or moreAfter 10 years of follow-up, the corresponding number of non-remission patients was 3 (27%), 11 (11%) and 41 (10%), respectivelyIn the multivariate analysis, patients treated by a professional rheumatologist within 6 weeks had higher rates of non-DMARD remission than those treated at 7 to 12 weeks (HR: 1.69) or 12 weeks (1.67)Meta analysis showed that 6 weeks or less of treatment was associated with higher persistent non-DMARD remission rates compared to patients treated at 7-12 weeks (HR 1.69) and 12 weeks or more (1.67)The multivariate analysis showed that patients treated by rheumatologists within six weeks had similar imaging progresses to the other two cohortsThe Meta analysis confirmed that treatment of 6 weeks or less did not improve imaging progression compared to treatment after 7 to 12 weeks, but had less associated with improved progressostal progression than treatment after 12 weeksstudies suggest that receiving professional treatment within six weeks of rheumatism may help to achieve sustained drug-free remission, but will not improve radiology progression