Treatment strategies in rheumatology

For many rheumatic diseases there are more than one type of medications that can be used. Not all are equally effective, and not all are effective in every patient. Sometimes several treatments must be tried before the patients notices improvement. Treatment strategy research focuses on questions such as – in which order should we start medication? – what is the place of new drugs? - can we predict who will do well on which type of treatment?

The treatment strategy research group is a collaboration of rheumatologists, PhD-students and research nurses. And patients!
To determine which is the best treatment strategy for a particular type of rheumatic disease, large studies are designed and conducted that are aimed to innovate anti-rheumatic treatment strategies, while fitting in the current pattern of patient care. Patients are asked to allow that randomization will determine in which order medication will be tried. The nurses will evaluate whether sufficient improvement has been achieved. Together nurses and patients collect data that will determine at the end of the study what is the best way to treat future patients.

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The treatment strategy research group is a collaboration of rheumatologists, PhD-students and research nurses. And patients!
To determine which is the best treatment strategy for a particular type of rheumatic disease, large studies are designed and conducted that are aimed to innovate anti-rheumatic treatment strategies, while fitting in the current pattern of patient care. Patients are asked to allow that randomization will determine in which order medication will be tried. The nurses will evaluate whether sufficient improvement has been achieved. Together nurses and patients collect data that will determine at the end of the study what is the best way to treat future patients.

The BeSt, the PROMPT, the IMPROVED, the RECALL and the I CEA.
For patients with rheumatoid arthritis, the results of the BeSt and the IMPROVED studies have changed the way we treat such patients today: we start medication as early as we can and aim to suppress all inflammatory activity as rapidly as we can. This way we can prevent that damage to the joints occurs, and this ensures that patients do not become invalids, as happened in the past. Also, many patients, once the inflammation has stopped, can reduce the amount of medication they have to use, or can stop taking antirheumatic drugs altogether. Currently we are inviting former participants of the BeSt and IMPROVED study to participate in the RECALL study, to let us know how they are doing today.

The PROMPT study was set up to aim at similar improvements in patients with undifferentiated arthritis, and now the I CEA study has started to see if we can do even better and rapidly cure early arthritis. The I CEA study is open for patients with undifferentiated arthritis.

In the international METEOR database anonymized data are collected from patients from all the world who are treated for rheumatoid arthritis. The data are used to study and potentially resolve international differences in rheumatoid arthritis treatments and disease outcomes.

Projects

Our team members

  • C.F. Allaart, MD, PhD, internist, senior consultant in rheumatology
  • Principle investigator of treatment strategy studies BeSt, IMPROVED, RECALL, I CEA and others
  • S.A. Bergstra, PhD, post-doctorate investigator, coordinator of the international METEOR database
  • Sub-investigators and PhD students:
  • L. van Ouwerkerk, MD
  • S.L. Heckert, MD
  • I.S Nevins, MD
  • J. van der Pol, MD