Abstract
Clinical Course and Sustained Remission in Rheumatoid Arthritis
Highlights
Rheumatoid arthritis (RA) is an inflammatory, multisystemic autoimmune disease
Evidence sustains that the disease prospects of patients newly diagnosed with RA today are much better than they were decades ago, and that this seems to be the result of several changes in treatment strategies [9,10,11]
The time to intervention within a limited time frame is associated with a effective response to therapy, resulting in long term sustained outcomes [11]. In spite of these evidence, a study on Undifferentiated peripheral inflammatory arthritis (UPIA) [13] showed a delay on treatment of patients with persistent synovitis that didn’t fulfilled the 1987 American College of Rheumatology (ACR) classification criteria for RA, reflecting the reluctance to prescribe disease-modifying antirheumatic drugs (DMARDs) in these patients, and the consequent continued prognostic and diagnostic uncertainty
Summary
Rheumatoid arthritis (RA) is an inflammatory, multisystemic autoimmune disease. It affects 0.5% of the population and has been described as an often progressive chronic disease, characterized by severe functional decline, radiographic progression, frequent work disability and premature mortality [1,2]. It is recognized that RA has a heterogeneous spectrum varying from mild, self-limited arthritis to severe permanently active and erosive polyarthritis leading to progressive joint damage, functional disability [3] and extra-articular manifestations [4]. It remains unanswered if the wide spectrum of clinical phenotypes is determined by a different set of risk factors, or if the subsequent course represents different diseases from the very beginning [4]. We may assume that at least part of the clinical course of the disease can be modified by appropriate clinical management
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