Investigating the Efficacy of Early Intervention Strategies in Preventing Joint Damage in High Risk Rheumatoid Arthritis Patients

Sharmeen Aslam; Mubasshra Iqbal; Muhammad Shaheryar; Muhammad Arslan

doi:10.70749/ijbr.v3i4.1033

Authors

Sharmeen Aslam THQ Hospital Shahpur/ Nishtar Medical University, Multan, Punjab, Pakistan.
Mubasshra Iqbal Department of General Medicine, Rawal Institute of Health Sciences, Islamabad, Pakistan.
Muhammad Shaheryar RHC Moazmabad Sargodha, Govt of the Punjab Health and Population Department/ DHQ Hospital Sargodha, Punjab, Pakistan.
Muhammad Arslan Department of Internal Medicine and Infectious Diseases, Mujahid Hospital Faisalabad, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i4.1033

Keywords:

Rheumatoid Arthritis, Early Intervention, DMARDs, Joint Damage, ACR20, DAS28, Randomized Controlled Trial

Abstract

Objectives: To evaluate the clinical and radiographic efficacy of early DMARD initiation in preventing joint damage among high-risk RA patients. Study Settings: Rheumatology Department, tertiary care hospital. Duration of Study: 12 months. Data Collection: This prospective randomized controlled trial included 256 patients with newly diagnosed high-risk RA, stratified into Early (DMARDs within 6 weeks of symptom onset) and Delayed (DMARDs after 6 months) intervention groups. Patients were assessed using DAS28, HAQ-DI, and Sharp/van der Heijde scores over 12 months. ACR20 response and radiographic progression were primary outcomes. Results:The Early group showed significantly greater clinical improvement and joint preservation. ACR20 was achieved in 55.5% of the Early group vs. 28.1% in the Delayed group (p = 0.0000). Mean reduction in DAS28 score was greater in the Early group (from 5.58 to 3.56) than in the Delayed group (to 4.57; p = 0.0000). Radiographic progression was significantly lower in the Early group, with a Sharp score increase of 0.49 vs. 2.69 in the Delayed group (p = 0.0000). Conclusion: Early intervention with DMARDs significantly improves clinical outcomes and prevents joint damage in high-risk RA patients.

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