Detailed information from longitudinal studies about the course and functional outcome of early RA is sparse (1,2). it would be optimal to study a cohort of patients with very early RA but this is seldom done because very few rheumatologists see enough patients with early RA to be able to perform a methodologically sound study. Eberhardt and Fex in a prospective study recently reported the functional outcome of 67 early RA patients followed for 5 years (3). To develop strategies to solve such methodological problems, Dr. Paulus and colleagues formed a Consortium of Practicing rheumatologists (CPR) in 1992 of over 50 physician practices to enroll and additive cohort of patients with very early RA and collect detailed information on the early course and outcome of RA in a 5 to 10 year long term observational study. The goals of this CPR based """"""""Long-term Observation of Severe Early Rheumatoid Arthritis"""""""" study are to identify pre-erosive features that predict the development of joint erosions within 2 years of disease onset, determine whether the development of joint erosions correlate with subsequent disability, costs for medical care and dependence on others, and to observe whether various therapies prevent or delay the onset of joint erosions. Disease status will be assessed in the CPR study at entry, 6 months, and yearly thereafter by traditional assessments, health services methodologies, and joint radiographs. Specifically, tender and swollen joint counts, Westergren ESR (WSR), pain assessment, global assessments, and functional (physical, mental and social) status will be among the disease activity measures that will be evaluated in the CPR study. In addition, patient plasma and serum specimens will be drawn and maintained in a freezer bank for future use testing. Information will be obtained directly from the patients using ARAMIS-based background information forms and the Health Assessment questionnaire (HAQ). The initial set of forms will be given to the patient by the physician, to be mailed back directly to the Coordinating Center at UCLA when completed. Subsequent patient-based data forms for patient completion will be sent directly to the patients from the Coordinating Center.
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