RESEARCH - Early RA - is there a window of opportunity?

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J Rheumatol Suppl. 2007 Nov;80:1-7.

Early rheumatoid arthritis -- is there a window of opportunity?

Cush JJ.

Department of Clinical Rheumatology, Baylor Research Institute,

Dallas, Texas 75231, USA.

The early diagnosis and treatment of nascent rheumatoid arthritis (RA)

has become a prime objective for rheumatologists and clinicians who

care for patients with arthritis. Population-based studies have

consistently shown that patients with RA are at substantial risk for

progressive joint damage, disability, and increased morbidity and

mortality. These inevitable outcomes are closely linked to the

consequences of rheumatoid inflammation, which begins early and is

progressive in all. At issue is whether early diagnosis, coupled with

aggressive therapy, might alter the natural history of this RA. If

this " window of opportunity " exists, then outcomes should be

substantially altered by delivering the right therapies at the right

time. A growing body of evidence has emphasized the consistent

clinical and radiographic benefits of early, aggressive treatment of

RA. These studies confirm that all therapies - monotherapy,

combination disease modifying antirheumatic drugs (DMARD), biologics -

work better in early disease than in long-established RA. Earlier

identification, referral, and an accurate diagnosis of RA can now be

rewarded with highly effective DMARD or biologic therapies.

Rheumatologists should rise to the challenge and educate clinicians

about this window of opportunity, the potential for remission, and

superior clinical responses when patients with early RA or

undifferentiated arthritis are referred to and managed by experts in

aggressive rheumatologic care.

PMID: 17985417

http://www.ncbi.nlm.nih.gov/pubmed/17985417

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Not an MD