Evolving strategies in the treatment of rheumatoid arthritis: a historical perspective

Abstract

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by joint inflammation, degradation of cartilage and bone, and potential systemic effects. This paper provides a comprehensive historical overview of RA treatment, tracing the evolution from ancient empirical methods to modern targeted therapies. Advancements in the understanding of RA's immunopathology have led to the development of conventional, biological, and targeted disease-modifying antirheumatic drugs, including tumor necrosis factor α inhibitors and Janus kinase inhibitors. These innovations have been pivotal in transforming RA management, allowing for more personalized and effective treatment strategies. The historical progression in RA treatment reflects a shift from symptomatic management to targeted interventions aimed at the underlying mechanisms of the disease. This shift has not only improved clinical outcomes but also enhanced the quality of life for those affected by RA, underscoring the importance of ongoing research and adaptation of therapeutic strategies.

Keywords: JAK inhibitor; biologic DMARD; conventional synthetic DMARD; methotrexate; rheumatoid arthritis.