What have we learnt about the development and progression of early RA from RCTs?

Most randomized controlled trials (RCTs) investigating the treatment of early rheumatoid arthritis (RA) use the core set of measures proposed by consensus meetings in the 1990s; these include tender and swollen joint counts, pain, global assessments, disability, and acute-phase responders such as the erythrocyte sedimentation rate (ESR). Trials in early RA generally assess three key outcomes based on this core data set: symptoms and signs of inflammatory arthritis, progression of disability, and erosive damage. Adverse events are also recorded. This chapter considers the lessons learned from the various trials in terms of benefits and adverse effects of different treatment regimens.

Keywords: early rheumatoid arthritis, DMARD, randomized controlled trial, placebo-controlled trial