Early identification of rheumatoid arthritis

Leiden Repository

Early identification of rheumatoid arthritis

Type: Doctoral Thesis
Title: Early identification of rheumatoid arthritis
Author: Nies, Jessica Annemarie Bernadette van
Publisher: Department of Rheumatology, Faculty of Medicine, Leiden University Medical Center(LUMC), Leiden University
Issue Date: 2016-03-03
Keywords: Rheumatoid arthritis
Artralgia
Early arthritis
Window of opportunity
Survival
Abstract: The first part is focused on early recognition of Rheumatoid Arthritis (RA). Two large early arthritis recognition clinics were started in Leiden and Groningen. The results showed that this initiative reduces the GP-delay significantly. Secondly, it was investigated whether an association between shorter symptom duration and a beneficial outcome in RA exists. Furthermore, it was questioned whether there was a confined period in which the start of DMARD therapy has a more beneficial effect. In the third part of the thesis certain disease features/ symptoms were investigated in more detail to assess if they had a prognostic or diagnostic value in arthralgia, early arthritis or RA patients. Finally, in the last part focused on mortality in RA. It was observed that patients that were treated early and with aggressive DMARD therapy had no increased mortality compared to the Dutch general population. In conclusion, the current thesis showed that lots of progress was made in the attempt to recognize rheumatoid arthritis earlier, that a therapeutic window of opportunity exits and that with prompt initiation of adequate DMARD-treatment RA should no longer be tagged as a chronic condition but that drug-free remission and improved survival are both achievable goals.
Description: Promotores: T.W.J. Huizinga, A.H.M. van der Helm-van Mil
With Summary in Dutch
Faculty: LUMC
Citation: Nies, J.A.B., 2016, Doctoral Thesis, Leiden University
ISBN: 9789402800401
Sponsor: The printing of this thesis was financially supported by Lamepro B.V., Abbvie B.V., Pfizer B.V., Sanofi B.V., UCB Pharma B.V. and Chipsoft B.V., which is gratefully acknowledged.
Handle: http://hdl.handle.net/1887/38506
 

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application/pdf Part I: Chapter 2 818.6Kb View/Open Full text at publisher site
application/pdf Part I: Chapter 3 681.4Kb View/Open Full text at publisher site
application/pdf Part II: Chapter 4 707.0Kb View/Open Full text at publisher site
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application/pdf Part III: Chapter 9 1.013Mb View/Open Full text at publisher site
application/pdf Part IV: Chapter 10 605.8Kb View/Open Full text at publisher site
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application/pdf Summary in Dutch 534.3Kb View/Open
application/pdf Curriculum Vitae_Publications_Acknowledgements 291.4Kb View/Open
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