Combination therapy most common for early rheumatoid arthritis – results are good

Background We evaluated current treatment choices and results in early rheumatoid arthritis (RA) in Finland.

Methods Initial medication, disease activity and initiation of biologic therapy within one year were analysed in 359 RA patients from Tampere University Hospital (Tays) diagnosed between 2012-2019 and in 6705 patients from the FinRheuma Register diagnosed between 2016-2021. Factors predicting inadequate response to therapy were also evaluated.

Results Combination therapy was started by 84,7% of Tays patients. RA disease activity diminished significantly within 3 months. At 12 months 66,7% were in remission. High disease activity, older age, loss of function and monotherapy were factors predicting inadequate treatment response. FinRheuma Register patients were treated with combination therapy in 65% of cases. At 12 months approximately 70% of monitored patients were in remission. In both cohorts biologic therapy was initiated in <10% of patients.

Conclusions Combination therapy is widely used in patients with early RA leading to remission in two thirds of cases. The use of biologic therapy within one year is sparse. Being able to identify patients with high disease activity or experiencing poor response to conventional therapy gives room for early biological or targeted therapy.