Early rheumatoid arthritis
Identifieur interne : 001A74 ( Main/Exploration ); précédent : 001A73; suivant : 001A75Early rheumatoid arthritis
Auteurs : David L. Scott [Royaume-Uni]Source :
- British Medical Bulletin [ 0007-1420 ] ; 2007.
Abstract
Background This review outlines current knowledge of diagnosis, assessment, treatment and risk factors for early rheumatoid arthritis (RA). Methods Selective review of current literature was obtained by searching the terms ‘rheumatoid arthritis’ and ‘early’. Results Three issues dominate the current views on early RA. First, its recognition may be difficult. Many experts consider that early inflammatory arthritis should only be classified as RA after several months' of observation. Secondly, there is emphasis on early intensive treatment with conventional disease-modifying drugs or biologics, especially tumour necrosis factor inhibitors. Thirdly, there is a debate on the risk factors with evidence of genetic risks and environmental factors like smoking that may trigger RA. Developing citrullinated proteins followed by anti-cyclic citrullinated peptide antibodies, specific for RA, appears to be a crucial pathogenetic step. Discussion Early RA needs immediate specialist assessment and review. Early intensive therapy is effective but needs to be focussed on patients mostly at risk of severe progressive disease.
Url:
DOI: 10.1093/bmb/ldm011
Affiliations:
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