Repair of joint damage in patients with rheumatoid arthritis does not relate to previous suppression of inflammation: a subanalysis after 8 years treat-to-target in the BeSt-trial.

Objectives: To investigate whether repair of erosions and joint space narrowing (JSN) in rheumatoid arthritis (RA) occurs and whether clinical variables predict this.

Methods: Eight-year follow-up data of the BeSt-study were used. Patients with recent onset RA (1987 criteria) were randomised to four treatment strategies and treated-to-target (Disease Activity Score (DAS)≤2.

Comparison between low disease activity or DAS remission as treatment target in patients with early active rheumatoid arthritis.

Objectives: To compare outcomes of targeted treatment aimed at either low disease activity or remission in patients with early active rheumatoid arthritis (RA).

Methods: Five-year outcomes were compared in 133 patients with early active RA (1987), starting with methotrexate, sulfasalazine and tapered high dose of prednisone (arm 3 of the BehandelStrategieën (Treatment Strategies for Rheumatoid Arthritis) (BeSt) study), targeted at Disease Activity Score (DAS) ≤2.4 (low disease activity), and 175 patients with early RA, starting methotrexate and tapered high dose of prednisone, targeted at DAS <1.

An unusual causative pathogen of sepsis after a cat bite: Anaerobiospirillum succiniciproducens.

A 40-year-old woman with a history of liver cirrhosis presented with septic shock caused by an Anaerobiospirillum succiniciproducens bacteraemia after a cat bite. A. succiniciproducens sepsis can develop after a cat or dog bite, especially in immunocompromised hosts, or might occur after translocation from the gut flora.

What have we learned from BeSt?

Background: How have the long term outcomes of RA improved in the last decade?

Methods: Patients with DMARD naïve RA were randomized to 4 treatment strategies: 1. sequential DMARD monotherapy, 2. step-up combination therapy, 3.

[A skin lesion with ghost cells].

An 83-year-old woman presented with painful erythematous nodules on her feet and legs. Recently, she had been admitted several times because of pancreatitis of unknown cause. A biopsy showed fat cell necrosis with ghost cells and the diagnosis of pancreatic panniculitis was made.