Treatment of early rheumatoid arthritis.

Journal Article (Review;Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Geletka, R; St Clair, EW

Published Date

  • October 1, 2003

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 791 - 809

PubMed ID

  • 12915158

Electronic International Standard Serial Number (EISSN)

  • 1532-1770

International Standard Serial Number (ISSN)

  • 1521-6942

Digital Object Identifier (DOI)

  • 10.1016/s1521-6942(03)00044-5


  • eng