Symposium 7

Abstract

Pre-clinical rheumatoid arthritis (RA) is a phase of the disease that occurs before the characteristic symptoms and clinical manifestations of RA become evident. One key aspect of pre-clinical RA research has been the identification of biomarkers that can predict the development of RA in individuals who are at risk. Rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs) are often detectable in the pre-clinical phase, sometimes years before clinical onset. These biomarkers, along with genetic and environmental factors contribute to the risk profile for RA development. Synovial biopsy, serum and peripheral blood cell characterization, magnetic resonance imaging (MRI) and ultrasound, have allowed researchers to capture subclinical joint inflammation in individuals who do not yet exhibit clinical symptoms. This has provided valuable insights into the progression of RA, as well as the potential for early intervention to prevent irreversible joint damage. Understanding the pathogenesis of pre-clinical RA has revealed the role of several initial pathways that are relevant for the onset of the disease, paving the way for new treatment intervention and new very early diagnostic strategies. Ongoing research will continue to refine our understanding of this phase of the disease and optimize strategies for its management.