Early rheumatoid arthritis: Clinical aspects of new classification criteria and modern treatment strategies

• Published in: Arthritis & Rheumatology
• Main Author: Nordberg, Lena Bugge
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2019
• Subjects: Arctic; Bugge; Nordberg
• Online Access: http://hdl.handle.net/10852/71049; http://urn.nb.no/URN:NBN:no-74172

In this thesis Lena Bugge Nordberg assessed clinical aspects of new classification criteria and modern treatment for rheumatoid arthritis (RA). The thesis is based on data from the ARCTIC trial, in which 230 early RA patients were followed for 2 years. Nordberg examined whether the use of ultrasound, in addition to clinical examination, better identifies joints that will benefit from intra-articular glucocorticoid injections. The efficacy of injections was best if ultrasound showed active inflammation in the joint at the time of the injection. The findings support ultrasound as a tool for selection of joints for injection therapy. Nordberg also compared seropositive and seronegative patients fulfilling the new classification criteria for RA. At baseline, seronegative patients had markedly higher levels of joint inflammation than seropositive. After two years of treatment, disease outcomes were similar between groups. The findings suggest that patients now classified as seronegative RA have a more serious disease than before, and require intensive therapy. The results have also contributed to a discussion of the performance of the new classification criteria in seronegative patients.