Abstract
Despite considerable advances in the management of rheumatoid arthritis, results are still not satisfactory for all patients. The treatment goal in rheumatoid arthritis is remission, and there currently are numerous conventional and biological medications available to reach this aim. There are also different treatment strategies but with only limited comparative evidence about their efficacies. More patients now achieve remission while on treatment, but it remains elusive in the majority of patients. Treatment-free remission, the ultimate goal of therapy, is only achieved in very few patients; even when this happens, it is most likely due to the natural course of the disease rather than to any specific therapies. Modern treatment is based on the initiation of aggressive therapy as soon as the diagnosis is established, and on modifying or intensifying therapy guided by frequent assessment of disease activity. In this commentary we will discuss the current treatment paradigm as well as the possibility of an induction-maintenance regimen with biological disease-modifying antirheumatic drugs in early rheumatoid arthritis.
Highlights
The goals of treatment of rheumatoid arthritis (RA) include induction of disease remission and protection against progressive joint destruction [1]
A direct comparison between conventional diseasemodifying antirheumatic drugs (DMARDs) combinations with MTX plus antiTNF was needed, and such a comparison was made in both the Swedish Farmacotherapy (Swefot) and the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) clinical trials
This study showed that the long-term van Vollenhoven et al BMC Medicine 2014, 12:25 http://www.biomedcentral.com/1741-7015/12/25 efficacy of the combination of conventional DMARDs and prednisolone was not further improved by adding infliximab during the first six months of treatment
Summary
The goals of treatment of rheumatoid arthritis (RA) include induction of disease remission and protection against progressive joint destruction [1]. A direct comparison between conventional DMARD combinations with MTX plus antiTNF was needed, and such a comparison was made in both the Swedish Farmacotherapy (Swefot) and the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) clinical trials.
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