Comparison of Treatment Strategies in Early Rheumatoid Arthritis

Measurements: Primary end points were functional ability (Health Assessment Questionnaire) and Sharp–van der Heijde score for radiographic joint damage. Results: Groups 3 and 4 had more rapid clinical improvement during the first year; all groups improved further to a mean functional ability score of 0.6 (overall, P 0.257) and 42% were in remission (overall, P 0.690) during the second year. Progression of joint damage remained better suppressed in groups 3 and 4 (median scores of 2.0, 2.0, 1.0, and 1.0 in groups 1, 2, 3, and 4, respectively [P 0.004]). After 2 years, 33%, 31%, 36%, and 53% of patients in groups 1 through 4, respectively, were receiving single-drug therapy for initial treatment. There were no significant differences in toxicity.