Ten-year radiographic outcome in patients with rheumatoid factor positive rheumatoid arthritis treated with aggressive immunosuppressive combination therapy.
Darmawan John ,Rasker Johannes J ,Nuralim Hendri
ncbi.nlm.nih.gov
----------------------------------------------------------------------------We observed 10-year radiographic outcomes in patients with rheumatoid factor positive rheumatoid arthritis prospectively. Group I, II, and III comprised 87, 125, and 89 consecutive subjects with disease duration at presentation of less than 4, 4-24, and 25-255 months, respectively. Initial therapy was with combinations of pulse intravenous (i.v.) methylprednisolone (0-125 mg), cyclophosphamide (100-200 mg), methotrexate (MTX, 5-15 i.v. mg/week) and simultaneous oral cyclosporin A (CSA, 25 mg bid/tid). After disease was controlled i.v. therapy was tapered and switched to oral MTX + CSA. Outcomes from the Larsen Index and Erosive Joint Count were compared in cases and in dropouts with baseline and each other. Significant improvement in the Larsen Index and Erosive Joint Count was observed in Group I (p < 0.0001). In Group II and III the improvement or deterioration was not significant. The Larsen Index and Er! osive Joint Count deteriorated significantly in the dropouts compared with baseline and cases (p < 0.0001). In conclusion, in early RA, in a Malayo-Polynesian patient sample, radiological progression could be halted with aggressive combination treatment.

Abstracts from the Rheumatology Preceptor Team
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WHO-ILAR COPCORD STAGE II EDUCATION
in TREATMENT of
DMARDs REFRACTORY RHEUMATOID ARTHRITIS
with
Step-down Bridge Combination Therapy of Five Immunosuppressants
(John Darmawan Therapy/John Bridge Therapy)
By
RHEUMATOLOGY PRECEPTORSHIP PROGRAM
for
Primary Health Care Physicians (family physicians and general practitioners)

John Darmawan, MD, PhD, FACR
WHO Expert on Rheumatic Disease, Geneva, Switzerland
1902-1996;1996-2000;2003;2003-2008
Seroja Rheumatic Center
Jalan Seroja Dalam 7, Semarang 50136, Indonesia
Tel. 62 24 8316 496, 62 24 8447 345, Fax.62 24 8310 028
Email: jd131035@hotmail.com

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WHO-ILAR COPCORD STAGE II EDUCATION
in TREATMENT of
DMARDs REFRACTORY Lupus Nephritis
with
Step-down Bridge Combination Therapy of Five Immunosuppressants
By
RHEUMATOLOGY PRECEPTORSHIP PROGRAM
for
Primary Health Care Physicians (family physicians and general practitioners)

John Darmawan, MD, PhD, FACR
WHO Expert on Rheumatic Disease, Geneva, Switzerland
1902-1996;1996-2000;2003;2003-2008
Seroja Rheumatic Center
Jalan Seroja Dalam 7, Semarang 50136, Indonesia
Tel. 62 24 8316 496, 62 24 8447 345, Fax.62 24 8310 028
Email: jd131035@hotmail.com

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WHO-ILAR COPCORD STAGE II EDUCATION
in TREATMENT of
NSAIDs REFRACTORY Ankylosing Spondylitis
with
Step-down Bridge Combination Therapy of Five Immunosuppressants
By
RHEUMATOLOGY PRECEPTORSHIP PROGRAM
for
Primary Health Care Physicians (family physicians and general practitioners)

John Darmawan, MD, PhD, FACR
WHO Expert on Rheumatic Disease, Geneva, Switzerland
1902-1996;1996-2000;2003;2003-2008
Seroja Rheumatic Center
Jalan Seroja Dalam 7, Semarang 50136, Indonesia
Tel. 62 24 8316 496, 62 24 8447 345, Fax.62 24 8310 028
Email: jd131035@hotmail.com

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Remission in 2 months
in DMARD and John Bridge Therapy Refractory
active Rheumatoid Arthrits by combination of JBT with infliximab without oral and intravenous save weekly polyarticular corticosteroids  – a WHO-ILAR COPCORD Stage II Treatment – a 6 months observational study

John Darmawan, MD, PhD
WHO Expert on Rheumatic Disease, Geneva, Switzerland
Seroja Rheumatic Center, Semarang, Indonesia

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Case Presentations and slides of a clinical study from the Rheumatology Preceptor Team

Breakthrough
In the Treatment of Autoimmune Diseases
with John Bridge Therapy Validated by Primary Health Care Physicians In Rheumatoid Arthritis, Ankylosing Spondylitis, and Lupus Nephritis Including Lupus Nephrotic Syndrome, Lupus Thrombocytopenia, and Idiopathic Thrombocytopenia (ITP)

WHO-ILAR COPCORD Stage II Education of Treatment
by Rheumatology Preceptor Team comprising Primary Health Care or Family Physicians, who encountered patients with refractory Autoimmune Diseases, where no Primay Rheumatology Care is available

	John Darmawan, MD, PhD, FACR WHO Expert on Rheumatic Disease 1992-2008, Geneva, Switzerland, Coordinator, Rheumatology Preceptor Team Seroja Rheumatic Center, Semarang, Central Java Telephone:0248316496/8447345, Fax:0248310028 Hp:0811273670 Email:jd131035@hotmail.com
	Paulus Leswari, MD Air CLinic, Purwakarta, West Java (Home Jalan Jatinegara Barat II/3, Jakarta 13310) Hp:081573254068 Email:pkleswari@yahoo.com
	A.M. Ria Kusuma Dewi, MD Primary Health Care Jl. Kelapa Cengkir Barat 6 Blok FM 1 No. 26, Kelapa Gading, Jakarta 14240 Hp:0816802545 E-mail:graciahealth@yahoo.com
	Slamet Riyadi, MD PUSKESMAS Kota Tegal Barat, Tegal Fax:0283 323435 Hp:08156580509 Email:slamdr@plasa.com
	Sri Wiyati Sony, MD Primary Health Care. Jalan Jend. Sudirman Km 63008, Palembang Telephone:0711 355049 Hp:08127131049 Email:siwi_sri_sony@yahoo.com

Presentations by Rheumatology Preceptor Team

Presentation by John Darmawan.

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