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Abstract
Rheumatoid arthritis (RA) is common and leads to joint damage due to persistent synovitis. The persistence of inflammation is maintained by hyperplastic stromal tissue, which drives the accumulation of leukocytes in the synovium. Aggressive treatment after the first 3-4 months of symptoms, with either disease modifying anti-rheumatic drugs or anti-tumor necrosis factor (TNF)-alpha therapy, reduces the rate of disease progression. However, it rarely switches off disease such that remission can be maintained without the continued need for immunosuppressive therapy. There is increasing evidence that the first few months after symptom onset represent a pathologically distinct phase of disease. This very early phase may translate into a therapeutic window of opportunity during which it may be possible to permanently switch off the disease process. The rationale for, and approaches to, treatment within this very early window are discussed.
Original language | English |
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Pages (from-to) | 849-863 |
Number of pages | 15 |
Journal | Best Practice & Research: Clinical Rheumatology |
Volume | 20 |
Issue number | 5 |
Early online date | 16 Sept 2006 |
DOIs | |
Publication status | Published - 1 Oct 2006 |
Keywords
- DMARD
- rheumatoid arthritis
- anti-TNF-alpha therapy
- synovitis
- early arthritis
- therapy
- remission
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Dive into the research topics of 'Treating very early rheumatoid arthritis'. Together they form a unique fingerprint.Projects
- 1 Finished
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The Role of Fibroblasts in the Regulation of Leucocyte Retention in Chronic Inflammation
Buckley, C.
1/10/01 → 30/09/06
Project: Research Councils