What is the modern treatment philosophy in rheumatoid arthritis?
What is the modern treatment philosophy in rheumatoid arthritis?
Today, we are blessed with a deeper understanding of the pathogenesis and characteristics of RA and the availability of safe and effective medications that can alter the natural history of RA and improve function. We start with the premise that RA is eminently controllable, and the goal of our therapies is “no evidence of disease.” That means no signs of redness, warmth, swelling or tenderness and normal function. Since we would not accept uncontrolled illness in angina, chronic obstructive lung disease, hypertension or diabetes, we should similarly not accept it in RA. Luckily, today, we have the therapeutic tools to make this happen. Early treatment with disease-modifying drugs is mandatory in order to prevent joint damage and dysfunction (i.e. within the first two to three months after disease onset). Treatment will continue for at least five years and possibly throughout life. Medications, physical and occupational therapy, and education for patients and their families should be important components of every regimen.