PT  - JOURNAL ARTICLE
AU  - Tia Sandström
AU  - Vappu Rantalaiho
AU  - Timo Yli-Kerttula
AU  - Hannu Kautiainen
AU  - Timo Malmi
AU  - Anna Karjalainen
AU  - Tea Uusitalo
AU  - Heikki Julkunen
AU  - Oili Kaipiainen-Seppänen
AU  - Leena Paimela
AU  - Kari Puolakka
AU  - Toini Uutela
AU  - Timo Möttönen
AU  - Pekka Hannonen
AU  - Marjatta Leirisalo-Repo
AU  - Leena Laasonen
AU  - Markku Kauppi
AU  - for the NEO-RACo Study Group
TI  - Cervical Spine Involvement among Patients with Rheumatoid Arthritis Treated Actively with Treat-to-target Strategy: 10-year Results of the NEO-RACo Study
AID  - 10.3899/jrheum.190139
DP  - 2020 Aug 01
TA  - The Journal of Rheumatology
PG  - 1160--1164
VI  - 47
IP  - 8
4099  - http://www.jrheum.org/content/47/8/1160.short
4100  - http://www.jrheum.org/content/47/8/1160.full
SO  - J Rheumatol2020 Aug 01; 47
AB  - Objective. To evaluate the development of radiological changes of the cervical spine in patients with rheumatoid arthritis (RA) in the NEO-RACo trial treated with an intensive, remission-targeted combination of conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and additional infliximab (IFX) or placebo (PLA) for the first 6 months.Methods. Ninety-nine patients with early, DMARD-naive RA were treated with a triple combination of csDMARD and prednisolone, and randomized to double-blindly receive either IFX (FIN-RACo+IFX) or PLA (FIN-RACo+PLA) infusions during the first 6 months. After 2 years the treatment strategies became unrestricted, but the treatment goal was strict NEO-RACo remission. At the 10-year visit, radiographs of the cervical spine were taken of 85 patients (38 in the FIN-RACo+IFX group and 47 in the FIN-RACo+PLA group). The study was registered at ClinicalTrials.gov (NCT 00908089).Results. There were 4/85 patients (4.7%) with cervical spine involvement (CSI) by 10 years. Atlantoaxial subluxation was found in 2/85 patients (2.4%), both in the FIN-RACo+IFX group, and none in the FIN-RACo+PLA group. Atlantoaxial impaction was found in 1/85 patients (1.2%) in the FIN-RACo+IFX group. Subaxial subluxation was found in 1/85 patients (1.2%).Conclusion. Early and intensive remission-targeted treatment has reduced the incidence of CSI and our results show that intensive treatment also prevents its development in the long run.