Current concepts of treatment for rheumatoid arthritis

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Rheumatoid arthritis (RA) is a widespread disease affecting patients from all age groups. The primary goal of treatment is to achieve remission of RA and to slow the progression of joints destruction. In a proportion of patients with early RA all signs and symptoms may disappear completely while in established disease they are usually irreversible and persist even if treatment is effective. Thus, remission of RA cannot be frequently defined as a complete absence of signs and symptoms. In the recent years, the attitude of rheumatologists to RA as an incurable disease was partly revised as a result of earlier diagnosis and treatment with disease modifying antirheumatic drugs (DMARD) and the development biologic agents that selectively block the important pathways in the immunopathogenesis of RA. Early administration of DMARD can improve functional outcomes and even survival in patients with RA, while biologic agents can be used in patients who are refractory to standard treatment. A rational use of DMARDs and/or biologic agents has become a standard of treating disease to target, specified in EULAR guidelines.

Key words

Rheumatoid arthritis, DMARD, methotrexate, leflunomide, biologic agents.