Abstract
Prevention of rheumatoid arthritis is an ambitious therapeutic goal. Once it has developed, rheumatoid arthritis is characterised by high chronicity and often requires lifelong treatment.1,2 Sustained drug-free remission is rare, especially in seropositive disease, which is defined by the presence of rheumatoid factor and anti-citrullinated protein antibodies (ACPA).3 Onset of rheumatoid arthritis, characterised by joint swelling, is preceded by a pre-arthritis phase, in which patients show discrete symptoms (eg, pain), presence of autoantibodies (rheumatoid factor and ACPA), and subclinical signs of inflammation (eg, tenosynovitis) on an ultrasound or MRI scan.
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