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The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis
NAKAMURA H; NAGASHIMA M; ISHIGAMI S
INT ORTHOP , 2000, vol. 24, n° 5, p. 242-245 Doc n°: 98415 Localisation : Bibliothèque Universitaire de Médecine de Nancy Descripteurs : DA523 - POLYARTHRITE RHUMATOIDE We assessed the anti-rheumatic effects of radical multiple synovectomy (RaMS) in patients with rheumatoid arthritis (RA) who did not respond to intensive medical treatment. The selection of patients into three groups, A, B or C, was randomised. Patients assigned to group A (n = 28) continued the prescribed pre-operative medication and had RaMS. Patients assigned to group B (n = 20) were started on a combination therapy with disease-modifying anti-rheumatic drugs (DMARDs) after radical multiple synovectomy. Nineteen RA patients who were started on the same combination therapy as group B but who did not undergo surgery served as controls (group C). The clinical and radiographic findings were assessed for at least 3 years after surgery. Patients in the surgically treated groups (groups A and B) showed a significant reduction in the number of swollen and painful joints and in their ESR and serum CRP levels, and this effect was maintained for at least 3 years. More than 40% of the patients remained in clinical remission during the observation period. The surgical outcome seemed to be superior to that of the controls and did not differ between group A and group B. Articular destruction (assessed by the carpal height ratio) did not progress in the patients who were in clinical remission. Langue : ANGLAIS Identifiant basis : 2001214346 |
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