Strategies in early arthritis management.

There are indications that patients with mild early arthritis are undertreated with joint damage as a consequence. Therefore, we have designed a trial to test the hypothesis that a treatment strategy aimed at achieving and maintaining remission with (a combination of) disease modifying antirheumatic drugs including adalimumab leads to less joint damage than the usual care in patients with early, mild arthritis. In the active group, treatment is switched on the basis of a disease activity score (DAS44), which should become and remain under 1.6. The study duration is 2 years per patient.

After 2 years of treatment with a combination of antirheumatic drugs including adalimumab with the aim of achieving and maintaining remission in patients with mild arthritis, there is less radiographic progression than in patients treated with ususal care.

N/A

Methotrexate, in case of insufficient response followed by adalimumab, and then by a combination of methotrexate, sulfasalazine, hydroxychloroquin and prednisone versus usual care according to preference physician.