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Guidelines holding back RA patients

GPs' patients with rheumatoid arthritis are deteriorating while waiting for treatment because guidelines are causing unnecessary delays.

British Society for Rheumatology guidelines require patients with severe arthritis to have two separate assessments by a rheumatologist ­ a month apart ­ before they can receive anti-TNF therapy.

But researchers called for the stipulation to be scrapped after finding the second assessment made little difference to eventual treatment but caused harmful delays.

The study found 98.3 per cent of patients who fulfilled criteria for disease activity at their first test also did so at their second. But in the month's wait, patients suffered a 'small but significant deterioration', with an average increase of 0.16 in disease activity scores.

Study researcher Dr Chris Deighton, a consultant rheumatologist at Derbyshire Royal Infirmary, said: 'About 75 per cent of patients' DAS scores had deteriorated in that one month.'

The study was presented at the BSR conference in Glasgow this week.

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