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Rheumatoid arthritis is an
autoimmune disease in which the body's defenses attack its own tissues.
It is more common in women, tends to strike between the ages of 36 and
50, and results in a chronic destruction and deformity of the joints.
Approximately 3 out of 10 patients
with rheumatoid arthritis will develop the most severe form of the disease
over a 20-year period.
In the study researchers followed
over 100 patients with rheumatoid factor-positive arthritis. Rheumatoid
factor is a type of antibody found in the blood of about 70% of rheumatoid
arthritis patients. Those with more severe disease generally have such
antibodies.
At the beginning of the study,
treatment was restricted to four drugs, while after 1982 doctors had additional
drugs to treat the patients, including sulfasalazine and methotrexate.
However, most patients continued to be treated with no more than one drug
at a time.
The investigators observed
a disease progression of about 2% to 3% per year in terms of the joint
destruction. By the end of the study, two patients had the maximum score
in terms of joint destruction, while 23% had high scores.
People with the most severe
disease usually had at least three large joints, such as the hip, knee
or shoulder, surgically replaced.
The
Journal of Rheumatology 2002;29:688-692
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