The SWEFOT Trial

Taken from NRAS magazine, Winter 2011

An analysis of data collected as part of the Swedish SWEFOT trial, into the most effective drug management of early rheumatoid arthritis, showed that patients with a good initial response to methotrexate have excellent 2 year clinical outcomes, but  that bony changes, as seen on x-ray or other imaging techniques, are not fully prevented.
In the trial, all 487 patients started methotrexate (target dose 20 mg/week). After 3–4 months, 147 had low disease activity, equivalent to 3.2 or less using the DAS28 scoring. These patients were not randomly selected but were followed in regular care for 2 years and clinical outcomes and any bony changes were analysed.
They concluded that most early RA patients who achieve low disease activity after 3–4 months of methotrexate as a single therapy, continue to have low disease activity during 2 years follow-up, and additional treatment is needed infrequently. They also noted, however, that some bony changes occurs in most patients, and may be marked or severe in some, even despite sustained DAS28 remission.  Patients should therefore still be monitored closely for any progression in joint damage.