Recent Paradigm Shifts in the Diagnosis and Treatment of Rheumatoid Arthritis.
10.3904/kjim.2012.27.4.378
- Author:
Young Ok JUNG
1
;
Hyun Ah KIM
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea. kimha@hallym.ac.kr
- Publication Type:Review ; Research Support, Non-U.S. Gov't
- Keywords:
Rheumatoid arthritis;
Diagnosis;
Therapeutics
- MeSH:
Antibodies, Monoclonal/therapeutic use;
Antirheumatic Agents/therapeutic use;
Arthritis, Rheumatoid/*diagnosis/etiology/*therapy;
Biological Products/therapeutic use;
Humans;
Tumor Necrosis Factor-alpha/antagonists & inhibitors
- From:The Korean Journal of Internal Medicine
2012;27(4):378-387
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rheumatoid arthritis (RA) is a progressive inflammatory disease with severe symptoms of pain and stiffness. Chronic persistent inflammation of RA often leads to joint destruction, deformity and limitation of function, which ultimately results in significant deterioration of quality of life (QoL). RA is characterized pathogenetically by immunologically driven, chronic synovitis, and production of autoantibodies, such as rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Although the cause of RA is yet unknown, advances in the molecular biology led to in-depth understanding of its pathogenesis, and have fostered the recent development of novel treatments. The last decade has seen the dramatic change in the landscape of RA treatment with more aggressive therapy early in the disease course and with treatment guided by a structured assessment of disease activity, with the ultimate goal of reaching remission. In addition, prevention and control of joint damage and improvement in QoL are important goals. To achieve these goals, a multidisciplinary approach to reduce disease activity with disease modifying antirheumatic drugs and biological therapy is needed. We also need to find ways to identify those patients who are at risk for more rapid disease progression who would benefit from intensive therapy early in the course of disease.
