Early identification of patients with RA and in particular, those likely to suffer from more rapid joint damage, is important because of the likely benefit of early intervention with disease-modifying anti-rheumatic drugs (DMARDs) or biologic therapies. As appreciation of the gravity of the social and economic burden imposed by RA has grown, so has the recognition that more favourable clinical outcomes are achieved when inflammation is optimally suppressed. In particular, there is now compelling evidence that intervention with DMARDs early in the course of disease results in improved remission rates, magnitude of clinical benefit, and slowing of damage to joints. In addition, the armamentarium of therapeutics has grown. Of these, biologic therapeutics targeting TNF-α, particularly when used in combination with oral methotrexate, have enjoyed considerable success in suppressing inflammation and markedly inhibiting the progression of joint damage previously thought to be an unavoidable characteristic of RA.
http://www.rheumatoid.org.uk/article.php?article_id=578There is the AI mantra again: early, aggressive treatment; tight control; remission.