Étude et Suivi:Rheumatoid Arthritis in the 21st Century

Abstract

For over 20 years much research in rheumatoid arthritis (RA) has focused on early identification and treatment of patients to prevent longterm joint damage, disability, and morbidity. A multitude of studies have demonstrated that early intervention improves outcomes, and in particular, treatment during the so-called “window of opportunity,” when patients first develop inflammatory arthritis, may halt development of chronic symptoms altogether1,2. We have new classification criteria3, developed specifically to aid early identification of patients who are likely to need disease-modifying therapy, and a host of new biologic drugs, in particular anti-tumor necrosis factor therapies, that have revolutionized our ability to suppress disease activity4. So how close are we to achieving the aims of longterm remission and minimal disability in clinical practice? In this issue of The Journal , Combe, et al report on the 5 year outcomes of the well established French ESPOIR cohort5. The developers of the ESPOIR “ Etude et Suivi des POlyarthritis Indifferences Recentes ” cohort, established to study and monitor early undifferentiated polyarthritis, should be congratulated on establishing a large nationwide cohort of patients with early undifferentiated inflammatory arthritis, providing real-world data on the progression of RA over time. By monitoring patients seen in clinic at regular intervals … Address correspondence to Dr. Verstappen; E-mail: suzanne.verstappen{at}manchester.ac.uk