Patient Outcomes in the Treatment of Rheumatoid Arthritis : Informing tapering decisions

Despite the advances that have been made in the medical treatment of Rheumatoid arthritis (RA), challenges to further optimize care for patients remain. Two of these challenges will be the focus of this work:
First, despite the better medical outcomes the burden of disease in RA patients is still higher compared to the general population, which may be attributed, at least in part, to higher levels of psychological distress patients experience.
Second, continuous medical drug treatment for patients in remission is only justified if the benefits outweigh the disadvantages such as potential overtreatment, safety considerations and treatment costs.
These challenges resulted in the main objectives of this thesis:
1. To study the impact of psychosocial factors on patients with early RA, with special interest in the relationships between psychosocial factors and disease activity score and achievement of treatment goals
2. To study the effects of treatment de-escalation in patients with low disease activity or remission and aid rheumatologists in making informed decisions with regard to treatment de-escalation