Complications
Long-term significant outcome of rheumatoid arthritis (RA) if not treated adequately. In a review of biologic agents in patients with RA, almost all studies showed positive results with respect to work presenteeism.[201]
Long-term significant outcome of rheumatoid arthritis (RA) if not treated adequately.
Rheumatoid arthritis is a risk factor by itself, in addition to traditional cardiovascular risk factors. Patients with RA have more prevalent coronary artery disease, higher coronary calcium scores, more high risk plaques and multivessel disease compared with controls.[202]
Untreated rheumatoid arthritis (RA) leads to, on average, 8- to 10-year shortening of life span.
ILD is an increasingly recognized complication of rheumatoid arthritis (RA) and is associated with significant morbidity and mortality.[203]
Patients with RA-related ILD are at high risk of infection and drug toxicity, which, along with comorbidities, complicates further treatment decision-making.
A complication of long-standing rheumatoid arthritis (RA). It is defined by the presence of 3 conditions: RA, splenomegaly, and an abnormally low white blood cell count.
It affects <1% of patients with RA.
Dose is adjusted or treatment discontinued.
Treatment should be stopped while the infection is being treated. If serious, discontinuation of the TNF-alpha inhibitor should be considered. Repeated episodes should also lead to consideration of discontinuation.
This complication can occur at any time but is more common in the first 6 months after treatment is started.[196] One study showed that there is no increased risk of serious infection and malignancy among patients with early disease who have not previously been treated with disease-modifying antirheumatic drugs and/or methotrexate.[120]
Treatment should be discontinued.
This complication can occur at any time but may be more common early in treatment course.[197][198] One study showed that there is no increased risk of serious infection and malignancy among patients with early disease who have not previously been treated with disease-modifying antirheumatic drugs and/or methotrexate.[120]
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