Our findings infer that the standardized and uniform health care of osteoporotic patients in a country may reduce general fracture incidence and hospitalization in a cost-effective way.

The Central European Congress of Rheumatology (CECR) has been organized by seven Central European countries: Austria, Croatia, Czech Republic, Hungary, Poland, Slovakia, and Slovenia. These countries have lots of similarities, but also differences, with respect to rheumatology research. In this paper, based on questionnaires, we wish to demonstrate achievements and difficulties in rheumatology research performed in our region.

BackgroundRheumatoid arthritis (RA) is a chronic autoinflammatory joint disease which leads to the destruction of joints and disability of the patients. Anti-tumour necrosis factor (anti-TNF) drugs can halt radiological progression better than conventional DMARDs even in clinical non-responders.MethodsThe efficacy of anti-TNF plus methotrexate (MTX) treatment versus MTX monotherapy on clinical and radiological outcomes were compared in early rheumatoid arthritis (RA) patients in clinical practice by retrospective analysis of an observational cohort.49 early RA patients (group A) on first-line MTX monotherapy and 35 early RA patients (group B) on anti-TNF plus MTX treatment were selected from an observational cohort and evaluated retrospectively focusing on their first twelve months of treatment. Data on disease activity (DAS28) and functional status (HAQ-DI) were collected three monthly. One-yearly radiological progression was calculated according to the van der Heijde modified Sharp method (vdHS). Clinical non-responder patients in both groups were selectively investigated from a radiological point of view.ResultsDisease activity was decreased and functional status was improved significantly in both groups. One-yearly radiological progression was significantly lower in group B than in group A. The percentage of patients showing radiological non-progression or rapid radiological progression demonstrated a significant advantage for group B patients. In addition non-responder patients in group B showed similar radiological results as responders, while a similar phenomenon was not observed in patients in group A.ConclusionsClinical efficacy within our study was similar for tight-controlled MTX monotherapy as well as for combination treatment with anti-TNF and MTX. However MTX monotherapy was accompanied by more rapid radiological progression and less radiological non-progression. Anti-TNF plus MTX decreased radiological progression even in clinical non-responders supporting the advantage of anti-TNF plus MTX combination in dissociating clinical and radiological effects.

OBJECTIVES: Quality of life is a key parameter in describing the health status patients of rheumatoid arthritis. Construct validity of a generic (EQ‐5D) and a disease specific (RAQoL) quality of life instrument was tested with the intention of further use in clinical and health economic trials and burden of disease studies in Hungary. METHODS: RAQoL and EQ‐5D have been recently adapted into Hungarian. Authors analysed the demographic and QoL data from a cross‐sectional postal survey of patient with rheumatoid arthritis. The convergent validity of EQ‐5D, RAQoL scores has been compared to functional measurement scores from the Health Assessment Questioner (HAQ). Pearson correlation coefficients were used to assess the level of association. RESULTS: 81 patients participated in the study. Mean age of the sample was 57.3 (SD = 10.1) years, 89% (n = 72) were female. The average disease duration among patients was 14.5 (SD = 10.6) years. RAQoL scores were relatively strongly correlated (Pearson coefficient = 0.662) with HAQ scores. The EQ‐5D index scores showed higher correlation (0.627) with HAQ than the Visual Analogue Scale of EQ‐5D (0.463). The Pearson Correlation Coefficient between RAQoL and EQ‐5D index scores was 0.515, and between RAQoL and EQ‐5D VAS scores was 0.396. CONCLUSIONS: Results suggest that the Hungarian RAQoL is a valid instrument of measuring QoL of rheumatoid arthritis patients. The EQ‐5D index provides also appropriate results, and can be proposed for cost‐utility analyses. However EQ‐5D VAS scores are not recommended to describe the QoL of patients with rheumatoid arthritis.

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