REVIEW - New understanding and approaches to treatment in RA

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Br Med Bull. 2010;94:201-14. Epub 2010 Mar 2.

New understanding and approaches to treatment in rheumatoid arthritis.

Tayar JH, Suarez-Almazor ME.

Department of General Internal Medicine, AT and EC, Section of

Rheumatology, The University of Texas M D Cancer Center,

Houston, TX 77030, USA.

Abstract

Rheumatoid arthritis (RA) is the most common autoimmune inflammatory

polyarthritis. Significant advances in the understanding of its

pathogenesis have led in the past two decades to major advancement in

its therapy.

We used data from articles in Cochrane Database of Systematic Reviews

on 'rheumatoid arthritis', meta-analyses and randomized controlled

trials on adult RA (age >19 years) published in English within the

past 5 years and identified in PubMed, and other key papers on

management of RA.

Appropriate, early and aggressive therapy is required for confirmed

active cases of RA. The choice of disease-modifying drugs and

different combinations, especially the newer biologic agents in

regards of their early and long-term usage remains debated because of

high costs and long-term safety concerns.

Development of newer biologic agents working on different pathways of

inflammation is underway in different stages. It remains to be

determined how and when each of these agents will fit in the overall

management of RA. Furthermore, post-marketing surveillance of the

safety and response sustainability of these drugs is warranted.

PMID: 20200013

http://www.ncbi.nlm.nih.gov/pubmed/20200013

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