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Review
. 2015 Aug 15;1(Suppl 1):e000057.
doi: 10.1136/rmdopen-2015-000057. eCollection 2015.

Rheumatoid arthritis treatment: the earlier the better to prevent joint damage

Sara Monti  1 , Carlomaurizio Montecucco  1 , Serena Bugatti  1 , Roberto Caporali  1
Affiliations
Review

Rheumatoid arthritis treatment: the earlier the better to prevent joint damage

Sara Monti et al. RMD Open. .

Abstract

The management of rheumatoid arthritis has undergone major advances in recent years, both in terms of the drugs armamentarium and therapeutic strategy. Treating disease to target, aiming at remission, through a tight control protocol is regarded as the standard of care. Reaching clinical and radiographic disease remission has therefore become an achievable goal. Increasing evidence has demonstrated that early diagnosis, prompt treatment initiation and early achievement of remission are the major predictors of long-term clinical, functional and radiographic outcomes. Concentrating efforts in controlling disease activity in a very early window of opportunity offers unique sustained benefits. In this short review, we analysed the available evidence supporting the value of treating rheumatoid arthritis early and the impact on disease outcomes, with particular focus on radiographic progression.

Keywords: Early Rheumatoid Arthritis; Rheumatoid Arthritis; Treatment.

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Figures

Figure 1
Figure 1
The effect of early response to treatment on 5-year follow-up of radiographic progression rate. Adapted from Bakker et al (EULAR, European League Against Rheumatism; SHS, Sharp van der Heijde score, median values).
See this image and copyright information in PMC

References

    1. Smolen JS, Aletaha D, Bijlsma JWJ et al. . Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010;69:631–7. 10.1136/ard.2009.123919 - DOI - PMC - PubMed
    1. Möttönen T, Hannonen P, Leirisalo-Repo M et al. . Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomised trial. FIN-RACo trial group. Lancet 1999;353:1568–73. - PubMed
    1. Mäkinen H, Kautiainen H, Hannonen P et al. . Sustained remission and reduced radiographic progression with combination disease modifying antirheumatic drugs in early rheumatoid arthritis. J Rheumatol 2007;34:316–21. - PubMed
    1. De Cock D, Vanderschueren G, Meyfroidt S et al. . Two-year clinical and radiologic follow-up of early RA patients treated with initial step up monotherapy or initial step down therapy with glucocorticoids, followed by a tight control approach: lessons from a cohort study in daily practice. Clin Rheumatol 2014;33:125–30. 10.1007/s10067-013-2398-9 - DOI - PubMed
    1. Smolen JS, Landewé R, Breedveld FC et al. . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014;73:492–509. 10.1136/annrheumdis-2013-204573 - DOI - PMC - PubMed