Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, erosive arthritis that requires early and aggressive treatment.

Diagnosed clinically. Laboratory and radiographic testing provide prognostic information more often than diagnostic information.

Early and aggressive treatment with disease-modifying anti-rheumatic drugs (DMARDs), potentially combined with a biological agent or a targeted synthetic DMARD, is recommended.

Disease activity scores (e.g., 28-joint count version of disease activity score [DAS28], clinical disease activity index [CDAI], simplified disease activity index [SDAI], routine assessment patient index data [RAPID3]) are used routinely to provide optimum care for RA patients.

RA is a chronic inflammatory condition affecting around 1% of the population, making it the most common inflammatory arthritis seen by physicians.[1]Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet. 2001 Sep 15;358(9285):903-11. http://www.ncbi.nlm.nih.gov/pubmed/11567728?tool=bestpractice.com [2]Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014 Jul;73(7):1316-22. http://www.ncbi.nlm.nih.gov/pubmed/24550173?tool=bestpractice.com ​​[3]Safiri S, Kolahi AA, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis. 2019 Nov;78(11):1463-71. http://www.ncbi.nlm.nih.gov/pubmed/31511227?tool=bestpractice.com [4]Almutairi KB, Nossent JC, Preen DB, et al. The prevalence of rheumatoid arthritis: a systematic review of population-based studies. J Rheumatol. 2021 May;48(5):669-76. http://www.ncbi.nlm.nih.gov/pubmed/33060323?tool=bestpractice.com ​ It primarily affects the small joints of the hands and feet and, if not treated aggressively, can be a major cause of work loss, decreased quality of life, need for joint replacement surgery, and mortality.[5]Pincus T, Sokka T. How can the risk of long-term consequences of rheumatoid arthritis be reduced? Best Pract Res Clin Rheumatol. 2001 Mar;15(1):139-70. http://www.ncbi.nlm.nih.gov/pubmed/11358420?tool=bestpractice.com RA is a clinical diagnosis; laboratory and radiographic tests help to confirm the diagnosis and provide useful prognostic information.

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