Treatment of early rheumatoid arthritis.
Increasing attention has focused on the early treatment of rheumatoid arthritis (RA) because of the short time lag that can exist between the onset of synovitis and the development of joint damage and loss of function. For optimal benefit, treatment may need to begin in a theoretical 'window of opportunity' that exists within the first few weeks or months of disease onset. Current evidence suggests that early introduction of therapy with disease-modifying antirheumatic drugs (DMARDs) can slow the progression of joint damage and improve long-term outcomes. Moreover, results of several studies suggest that early treatment with two- and three-DMARD combinations can produce superior benefits compared with DMARD monotherapy. Although early DMARD therapy has proven ability to slow the pace of joint destruction, individual treatment decisions are problematic because of the difficulty in accurately predicting individual prognosis and differential responses to therapy. Controlled trials are needed in early disease to investigate these questions and to identify treatment strategies that can effectively induce sustained remission and prevent joint damage.
Duke Scholars
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Related Subject Headings
- Time Factors
- Humans
- Clinical Trials as Topic
- Arthritis, Rheumatoid
- Arthritis & Rheumatology
- Antirheumatic Agents
- 3202 Clinical sciences
- 1117 Public Health and Health Services
- 1103 Clinical Sciences
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Time Factors
- Humans
- Clinical Trials as Topic
- Arthritis, Rheumatoid
- Arthritis & Rheumatology
- Antirheumatic Agents
- 3202 Clinical sciences
- 1117 Public Health and Health Services
- 1103 Clinical Sciences