REVIEW - Early RA

April 10, 2006

Curr Opin Rheumatol. 2006 May;18(3):282-8.

Early rheumatoid arthritis.

Machold KP, Nell V, Stamm T, Aletaha D, Smolen JS.

Department of Rheumatology, Internal Medicine III, Vienna Medical

University, Austria.

PURPOSE OF REVIEW: This review provides novel and updated information on

pathogenesis, referral, and clinical characteristics as well as therapeutic

approaches in early rheumatoid arthritis. RECENT FINDINGS: Early referral is

important, but new classification criteria for early rheumatoid arthritis

need to be elaborated. Predictive markers for rheumatoid arthritis are still

confined to autoantibodies; respective algorithms have been presented. Other

biomarkers will still have to prove their usefulness. Magnetic resonance

imaging and sonography do not appear to sufficiently distinguish between

early rheumatoid and nonrheumatoid arthritis. Rheumatoid arthritis has

become milder at presentation in recent years. In its very early stages, the

cytokine profile reflects T-cell activation and switches to abundant

proinflammatory cytokines thereafter. Disease-modifying antirheumatic drugs

plus glucocorticoids are highly effective, as is early use of tumor necrosis

factor blockers plus methotrexate. Tight control of disease activity and

subsequent therapeutic adjustments are highly effective. Disease activity

indices that are simple to calculate have been presented and validated.

Early intensive therapy may lead to decrease in disability and cost

reduction in rheumatoid arthritis.

SUMMARY: Understanding of early arthritis is increasing, especially in

prognostic and therapeutic respects, and new treatment strategies appear to

improve the outcome in patients with early arthritis. Nevertheless, much

remains to be studied to better address the issue of early rheumatoid

arthritis.

PMID: 16582693

6582693

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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