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© 1986 British Society for Rheumatology


research-article

RHEUMATOID ARTHRITIS: TREATMENT WHICH CONTROLS THE C-REACTIVE PROTEIN AND ERYTHROCYTE SEDIMENTATION RATE REDUCES RADIOLOGICAL PROGRESSION

P. T. DAWES, P. D. FOWLER, S. CLARKE, J. FISHER, A. LAWTON and M. F. SHADFORTH

Staffordshire Rheumatology Centre, Haywood Hospital Stoke on Trent, Staffordshire, ST6 7AC, UK

Correspondence to: Address correspondence to Dr. P. T. Dawes

One hundred and fifty consecutive patients with active, rheumatoid arthritis were assessed and treated with gold. D-penicillamine. chloroquine or dapsone. Four groups were selected from these patients. Group I consisted of 60 patients who did not complete 12 months' therapy. Group II consisted of patients in whom ESR and C-reactive protein (CRP) fell to <30 mm/h and <20 mg/l. respectively, and remained at these levels between 6 and 12 months In group IV the ESR and CRP fell but remained >30 and >20. respectively, during the same period. Group III patients had variable ESRs and CRPs between 6 and 12 months. In groups II, III and IV there was a significant deterioration (p<0.01) in the hand and foot radiographs from 0 to 6 months. Between 6 and 12 months the radiographs in groups III and IV continued to show significant radiological progression (p<0.01), but those of group II did not alter These results suggest radiological deterioration continues during the first 6 months regardless of clinical response but thereafter, further deterioration is less likely to occur when the ESR and CRP are consistently controlled.

KEY WORDS: Rheumatoid arthritis, ESR, CRP, Radiological progression, Suppressive therapy


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