A specialist rheumatology consultation within six weeks of symptom onset has benefits for achieving sustained drug-free remission, but not for radiographic progression, reveals an observational cohort study published in Lancet Rheumatology .
Consulting a rheumatologist within 12 weeks of RA symptom onset is associated with less radiographic progression and a higher chance of achieving drug-free remission, but until recently it was not known if an initial visit within six weeks would lead to improved long-term outcomes.
In this study, patients were included from the Leiden Early Arthritis Clinic (N=1,025) and the French Etude et Suivi des Polyarthrites Indifferenciées Recentes (N=514).
Multivariable analyses showed that a time to encounter of ≤6 weeks was associated with a higher chance of achieving sustained disease-modifying antirheumatic drug (DMARD)-free remission than at 7-12 weeks (HR 1·69; 95% CI 1·10-2·5; P=·016) and >12 weeks (HR1·67; 95% CI 1·08-2·58; P=·020).
However, the shorter time to consultation was not associated with reduced severity of radiographic progression than at 7-12 weeks (β=0·99; 95% CI 0·95-1·04; P=·75), but was associated with less progression than at >12 weeks (HR 0·95; 95% CI 0·91-0·99; P=·028).
These beneficial effects show that earlier consultation may help reduce RA’s chronicity and improve patients’ lives.