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Lookup NU author(s): Philip Brown, Dr Arthur Pratt
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Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.Rheumatoid arthritis (RA) is one of the most common immune mediated inflammatory diseases. People with rheumatoid arthritis present with pain, swelling, and stiffness that typically affects symmetrically distributed small and large joints. Without effective treatment, significant joint damage, disability, and work loss develop, owing to chronic inflammation of the joint lining (synovium). Over the past 25 years, the management of this condition has been revolutionized, resulting in substantially higher levels of disease remission and better long term outcomes. This improvement reflects a paradigm shift towards early and aggressive pharmacological intervention coupled with a proliferation in treatment choice, in turn related to enhanced pathobiological understanding and the advent of new drugs for rheumatoid arthritis. Following an overview of these developments from a historical perspective, and with a general audience in mind, this review focuses on newer, targeted treatments in an ever evolving landscape. The review highlights ongoing areas of debate and unmet need, including the proportion of patients with persistent, difficult-to-treat disease, despite recent advances. Also discussed are personalized, strategic approaches to individual patients, the role for imaging in clinical decision making, and the goal of sustained, drug free remission and disease prevention in the future.
Author(s): Brown P, Pratt AG, Hyrich KL
Publication type: Review
Publication status: Published
Journal: BMJ
Year: 2024
Volume: 384
Pages: e070856
Online publication date: 17/01/2024
Acceptance date: 02/04/2018
ISSN (print): 1759-2151
ISSN (electronic): 0959-8138
URL: https://doi.org/10.1136/bmj-2022-070856
DOI: 10.1136/bmj-2022-070856
PubMed id: 38233032
