TY - JOUR
T1 - How does established rheumatoid arthritis develop, and are there possibilities for prevention?
AU - van Beers-Tas, Marian H.
AU - Turk, Samina A.
AU - van Schaardenburg, Dirkjan
PY - 2015
Y1 - 2015
N2 - Established rheumatoid arthritis (RA) is a chronic state with more or less joint damage and inflammation, which persists after a phase of early arthritis. Autoimmunity is the main determinant of persistence. Although the autoimmune response is already fully developed in the phase of early arthritis, targeted treatment within the first months produces better results than delayed treatment. Prevention of established RA currently depends on the success of remission-targeted treatment of early disease. Early recognition is aided by the new criteria for RA. Further improvement may be possible by even earlier recognition and treatment in the at-risk phase. This requires the improvement of prediction models and strategies, and more intervention studies. Such interventions should also be directed at modifiable risk factors such as smoking and obesity. The incidence of RA has declined for decades in parallel with the decrease of smoking rates; however, a recent increase has occurred that is associated with obesity
AB - Established rheumatoid arthritis (RA) is a chronic state with more or less joint damage and inflammation, which persists after a phase of early arthritis. Autoimmunity is the main determinant of persistence. Although the autoimmune response is already fully developed in the phase of early arthritis, targeted treatment within the first months produces better results than delayed treatment. Prevention of established RA currently depends on the success of remission-targeted treatment of early disease. Early recognition is aided by the new criteria for RA. Further improvement may be possible by even earlier recognition and treatment in the at-risk phase. This requires the improvement of prediction models and strategies, and more intervention studies. Such interventions should also be directed at modifiable risk factors such as smoking and obesity. The incidence of RA has declined for decades in parallel with the decrease of smoking rates; however, a recent increase has occurred that is associated with obesity
U2 - https://doi.org/10.1016/j.berh.2015.09.001
DO - https://doi.org/10.1016/j.berh.2015.09.001
M3 - Article
C2 - 26697764
SN - 1521-6942
VL - 29
SP - 527
EP - 542
JO - Best practice & research. Clinical rheumatology
JF - Best practice & research. Clinical rheumatology
IS - 4-5
ER -