When the first visit to the rheumatologist is established rheumatoid arthritis
The outlook for people living with rheumatoid arthritis (RA) has improved tremendously in a generation. Major contributions to this include recognition of the importance of early treatment initiation, improved understanding of the pathobiology, the identification of therapeutic targets and their sub...
Main Authors: | , |
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Format: | Journal article |
Language: | English |
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Elsevier
2020
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_version_ | 1797079796394491904 |
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author | Taylor, P Law, S |
author_facet | Taylor, P Law, S |
author_sort | Taylor, P |
collection | OXFORD |
description | The outlook for people living with rheumatoid arthritis (RA) has improved tremendously in a generation. Major contributions to this include recognition of the importance of early treatment initiation, improved understanding of the pathobiology, the identification of therapeutic targets and their subsequent validation in clinic trials and the realisation of the importance of ‘tight control’ of inflammatory responses. Despite these advances, many patients meeting classification criteria present for the first time to a rheumatologist with longstanding symptoms. There is no definition as to when RA becomes ‘established’. But there is evidence that a ‘window of opportunity’ exists over about 12–16 weeks symptom duration, during which treatment intervention gives rise to the most optimal outcomes. This review addresses issues regarding the management of patients presenting outside the window of opportunity in terms of heterogeneity of presentation, assessment, therapeutic goals and treatment options as well as the importance of a multidisciplinary approach to holistic care.
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first_indexed | 2024-03-07T00:50:54Z |
format | Journal article |
id | oxford-uuid:865d5317-aa55-488a-9efb-bbde8cd3b771 |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-07T00:50:54Z |
publishDate | 2020 |
publisher | Elsevier |
record_format | dspace |
spelling | oxford-uuid:865d5317-aa55-488a-9efb-bbde8cd3b7712022-03-26T22:03:30ZWhen the first visit to the rheumatologist is established rheumatoid arthritisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:865d5317-aa55-488a-9efb-bbde8cd3b771EnglishSymplectic Elements at OxfordElsevier2020Taylor, PLaw, SThe outlook for people living with rheumatoid arthritis (RA) has improved tremendously in a generation. Major contributions to this include recognition of the importance of early treatment initiation, improved understanding of the pathobiology, the identification of therapeutic targets and their subsequent validation in clinic trials and the realisation of the importance of ‘tight control’ of inflammatory responses. Despite these advances, many patients meeting classification criteria present for the first time to a rheumatologist with longstanding symptoms. There is no definition as to when RA becomes ‘established’. But there is evidence that a ‘window of opportunity’ exists over about 12–16 weeks symptom duration, during which treatment intervention gives rise to the most optimal outcomes. This review addresses issues regarding the management of patients presenting outside the window of opportunity in terms of heterogeneity of presentation, assessment, therapeutic goals and treatment options as well as the importance of a multidisciplinary approach to holistic care. |
spellingShingle | Taylor, P Law, S When the first visit to the rheumatologist is established rheumatoid arthritis |
title | When the first visit to the rheumatologist is established rheumatoid arthritis |
title_full | When the first visit to the rheumatologist is established rheumatoid arthritis |
title_fullStr | When the first visit to the rheumatologist is established rheumatoid arthritis |
title_full_unstemmed | When the first visit to the rheumatologist is established rheumatoid arthritis |
title_short | When the first visit to the rheumatologist is established rheumatoid arthritis |
title_sort | when the first visit to the rheumatologist is established rheumatoid arthritis |
work_keys_str_mv | AT taylorp whenthefirstvisittotherheumatologistisestablishedrheumatoidarthritis AT laws whenthefirstvisittotherheumatologistisestablishedrheumatoidarthritis |