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

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Abstract
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 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.