[Rheumatoid arthritis today]

Abstract

Advances in the therapy of rheumatoid arthritis with disease modifying antirheumatic drugs (DMARD) such as methotrexate and biological response modifiers in particular, have turned a chronic progressive disease with significant invalidity and mortality into one that can be well controlled. To prevent irreversible damage, early diagnosis is essential. DMARD therapy needs to be instituted within three months after symptom onset - a clinical and organisational challenge. Long term DMARD therapy is monitored using standardized scores and modified whenever not sufficiently successful. Analgesia, physiotherapy and occupational therapy as well as orthopaedic surgery play important roles in the management of rheumatoid arthritis. Consequent multimodal therapy can decisively influence the course of the disease and prevent or at least minimize damage.