Modern management of rheumatoid arthritis—making a case for early aggressive medical treatment

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that affects approximately 1% of the adult population. Some 30 to 40% of patients experience work disability within five years of onset of the disease, but early aggressive medical treatment has vastly improved the long-term outcome of RA. The combination of simple clinical tools to measure disease activity, the use of traditional disease-modifying anti-rheumatic drugs (DMARDs) early in the course of the disease and the introduction of targeted biologic agents for DMARD-resistant disease has greatly reduced the risk of joint deformities, physical disability and premature death. The family practitioner, by suspecting RA early in its course and jointly monitoring efficacy and toxicity of DMARDs with the rheumatologist, plays a pivotal role in improving the care and outcome of the RA patient.