Extra-Articular Manifestations of RA Have Declined Since 2000

Research suggests disease-modifying drugs may be changing natural history of rheumatoid arthritis

THURSDAY, Aug. 26 (HealthDay News) -- The prevalence of extra-articular manifestations (EAMs) of rheumatoid arthritis (RA) has declined in recent years, with the timing and pattern of the decline indicating that disease-modifying RA treatments may be changing the natural history of the disease, according to a study in the September issue of Rheumatology.

Christie M. Bartels, M.D., of the University of Wisconsin in Madison, and colleagues conducted a retrospective cohort study using a data set including both inpatients and outpatients with RA in the U.S. Veterans Health Administration system. The purpose of the study was to determine trends in the prevalence of serious EAMs in patients with RA from 1985 to 2006.

Hospitalizations for RA decreased over the study period, which the authors noted was a good justification for including both inpatients and outpatients in this type of study. Trends for specific EAMs varied, showing linear declines in fibromyalgia syndrome, increases in RA lung disease (possibly reflecting increased diagnostic sensitivity), and significant breakpoint declines in carditis and pooled serious EAMs. Pooled EAM prevalence dropped around 2000, from 10 percent among inpatients to less than 7 percent among both inpatients and outpatients by 2006.

"Simultaneous breakpoints in the prevalence of serious EAMs of RA demonstrated in this study suggest true declines in serious RA extra-articular disease. Declines in EAMs add credence to theories that aggressive disease-modifying treatments are changing the natural history of RA," the authors write.

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