Abstract
Rheumatoid arthritis (RA) is an autoimmune disease resulting from a largely unknown interaction between genetically determined and environmental factors. Progress in the understanding of this chronic inflammation in the synovial lining of joints has led to the insight that one cytokine, tumor necrosis factor (TNF), has an important role. This insight started the development of a series of targeted and highly effective therapeutics for RA and a range of other autoinflammatory diseases. RA has changed from a severely debilitating disease into a disease where progression can be stopped in most of the patients.
Highlights
Rheumatoid arthritis (RA) is a severe disease frequently resulting in disability
When I started rheumatology training in 1980, wheelchairs dominated the view of the rheumatology clinic and patients were admitted with gross skeletal destruction and signs of severe systemic inflammation
This observation about better reponse from patients treated early with infliximab + methotrexate suggests a window of opportunity where early powerful therapies result in long-lasting remission
Summary
Rheumatoid arthritis (RA) is an autoimmune disease resulting from a largely unknown interaction between genetically determined and environmental factors. Progress in the understanding of this chronic inflammation in the synovial lining of joints has led to the insight that one cytokine, tumor necrosis factor (TNF), has an important role. This insight started the development of a series of targeted and highly effective therapeutics for RA and a range of other autoinflammatory diseases. RA has changed from a severely debilitating disease into a disease where progression can be stopped in most of the patients.
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