The importance of early treatment for the prognosis of rheumatoid arthritis

Chronic synovial inflammation in rheumatoid arthritis (RA) leads to progressive damage to articular cartilage and bone, ultimately resulting in disability. Therefore, control of the articular inflammation is of great importance to prevent joint damage. A variety of disease-modifying antirheuma...

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Main Authors: Diego Kyburz, Axel Finckh
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2013-09-01
Series:Swiss Medical Weekly
Subjects:
Online Access:https://www.smw.ch/index.php/smw/article/view/1749
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author Diego Kyburz
Axel Finckh
author_facet Diego Kyburz
Axel Finckh
author_sort Diego Kyburz
collection DOAJ
description Chronic synovial inflammation in rheumatoid arthritis (RA) leads to progressive damage to articular cartilage and bone, ultimately resulting in disability. Therefore, control of the articular inflammation is of great importance to prevent joint damage. A variety of disease-modifying antirheumatic drugs (DMARDs) are available for RA patients. Conventional synthetic DMARDs, and in particular biological DMARDs, have been shown to effectively inhibit joint destruction in RA. Longitudinal assessments of radiographic changes in patients with RA in clinical trials and in large patient registries have clearly shown that delays in the initiation of DMARD therapy results in significantly increased progression of joint damage. Patients started early on DMARDs had significantly lower radiographic damage progression than patients initiating DMARD treatment later. These effects were maintained for several years, suggesting that early in the development of RA a therapeutic window of opportunity exists in which DMARD therapy decisively influences the long-term prognosis. Therefore, to improve the clinical outcome of RA, our efforts should be directed towards diagnosing RA earlier and introducing DMARD therapy immediately after the diagnosis has been made.   Key words: biologic; bone erosion; DMARD; joint damage; radiographic progression; rheumatoid arthritis; SCQM; window of opportunity
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spelling doaj.art-eadbfd69143d4e7596893d3bef0701342022-12-22T04:24:39ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-09-01143373810.4414/smw.2013.13865The importance of early treatment for the prognosis of rheumatoid arthritisDiego KyburzAxel Finckh Chronic synovial inflammation in rheumatoid arthritis (RA) leads to progressive damage to articular cartilage and bone, ultimately resulting in disability. Therefore, control of the articular inflammation is of great importance to prevent joint damage. A variety of disease-modifying antirheumatic drugs (DMARDs) are available for RA patients. Conventional synthetic DMARDs, and in particular biological DMARDs, have been shown to effectively inhibit joint destruction in RA. Longitudinal assessments of radiographic changes in patients with RA in clinical trials and in large patient registries have clearly shown that delays in the initiation of DMARD therapy results in significantly increased progression of joint damage. Patients started early on DMARDs had significantly lower radiographic damage progression than patients initiating DMARD treatment later. These effects were maintained for several years, suggesting that early in the development of RA a therapeutic window of opportunity exists in which DMARD therapy decisively influences the long-term prognosis. Therefore, to improve the clinical outcome of RA, our efforts should be directed towards diagnosing RA earlier and introducing DMARD therapy immediately after the diagnosis has been made.   Key words: biologic; bone erosion; DMARD; joint damage; radiographic progression; rheumatoid arthritis; SCQM; window of opportunity https://www.smw.ch/index.php/smw/article/view/1749biologicbone erosionDMARDjoint damageradiographic progressionrheumatoid arthritis
spellingShingle Diego Kyburz
Axel Finckh
The importance of early treatment for the prognosis of rheumatoid arthritis
Swiss Medical Weekly
biologic
bone erosion
DMARD
joint damage
radiographic progression
rheumatoid arthritis
title The importance of early treatment for the prognosis of rheumatoid arthritis
title_full The importance of early treatment for the prognosis of rheumatoid arthritis
title_fullStr The importance of early treatment for the prognosis of rheumatoid arthritis
title_full_unstemmed The importance of early treatment for the prognosis of rheumatoid arthritis
title_short The importance of early treatment for the prognosis of rheumatoid arthritis
title_sort importance of early treatment for the prognosis of rheumatoid arthritis
topic biologic
bone erosion
DMARD
joint damage
radiographic progression
rheumatoid arthritis
url https://www.smw.ch/index.php/smw/article/view/1749
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