REVIEW - Treating very early RA

[Guest guest]

doi:10.1016/j.berh.2006.05.005

Treating very early rheumatoid arthritis

Karim Raza MRCP, PhD, , Clinical Senior Lecturer, Caitriona E. Buckley

MRCP, Rheumatology Specialist Registrar, Mike Salmon FRCPath, PhD,

Professor of Experimental Rheumatology and D. Buckley

MRCP, PhDa, ARC Professor of Rheumatology

aRheumatology Research Group, Division of Immunity and Infection,

Institute of Biomedical Research, MRC Centre for Immune Regulation,

University of Birmingham, Birmingham B15 2TT, UK

Rheumatoid arthritis (RA) is common and leads to joint damage due to

persistent synovitis. The persistence of inflammation is maintained by

hyperplastic stromal tissue, which drives the accumulation of

leukocytes in the synovium. Aggressive treatment after the first 3¨C4

months of symptoms, with either disease modifying anti-rheumatic drugs

or anti-tumor necrosis factor (TNF)-¦Á therapy, reduces the rate of

disease progression. However, it rarely switches off disease such that

remission can be maintained without the continued need for

immunosuppressive therapy. There is increasing evidence that the first

few months after symptom onset represent a pathologically distinct

phase of disease. This very early phase may translate into a

therapeutic window of opportunity during which it may be possible to

permanently switch off the disease process. The rationale for, and

approaches to, treatment within this very early window are discussed.

http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6WBJ-4KWYWWD-4 & _user=1\

0 & _rdoc=1 & _fmt= & _orig=search & _sort=d & view=c & _version=1 & _urlVersion=0 & _userid=10 & \

md5=b83133e64f0c9b33832f681418153b61

Not an MD

[Guest guest]

,

March of last year (2007) my former " quack " gp told me that I had a

little touch of RA and when I had another really bad flare he would

refer me to a rheumatologist. He had already given me prednisone and

the inflammation was much better.

I came home and started searching on the internet. That may have

been when I joined this group, not sure though. Everything I read

was against waiting. I made another appointment with him and

insisted on a referral right then. Of course it took months to get

in. This is so important and if I could find the information how

could a doctor not know, or was it that he didn't care?

Shirley

>

> doi:10.1016/j.berh.2006.05.005

>

>

> Treating very early rheumatoid arthritis

>

>

> Karim Raza MRCP, PhD, , Clinical Senior Lecturer, Caitriona E.

Buckley

> MRCP, Rheumatology Specialist Registrar, Mike Salmon FRCPath, PhD,

> Professor of Experimental Rheumatology and D. Buckley

> MRCP, PhDa, ARC Professor of Rheumatology

>

> aRheumatology Research Group, Division of Immunity and Infection,

> Institute of Biomedical Research, MRC Centre for Immune Regulation,

> University of Birmingham, Birmingham B15 2TT, UK

>

>

> Rheumatoid arthritis (RA) is common and leads to joint damage due

to

> persistent synovitis. The persistence of inflammation is

maintained by

> hyperplastic stromal tissue, which drives the accumulation of

> leukocytes in the synovium. Aggressive treatment after the first

3¨C4

> months of symptoms, with either disease modifying anti-rheumatic

drugs

> or anti-tumor necrosis factor (TNF)-¦Á therapy, reduces the rate of

> disease progression. However, it rarely switches off disease such

that

> remission can be maintained without the continued need for

> immunosuppressive therapy. There is increasing evidence that the

first

> few months after symptom onset represent a pathologically distinct

> phase of disease. This very early phase may translate into a

> therapeutic window of opportunity during which it may be possible

to

> permanently switch off the disease process. The rationale for, and

> approaches to, treatment within this very early window are

discussed.

>

>

> http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6WBJ-

4KWYWWD-

4 & _user=10 & _rdoc=1 & _fmt= & _orig=search & _sort=d & view=c & _version=1 & _urlV

ersion=0 & _userid=10 & md5=b83133e64f0c9b33832f681418153b61

>

>

>

> Not an MD

>