Best Practice & Research Clinical Rheumatology
Volume 23, Issue 1 , Pages 93-102, February 2009

Drug management of early rheumatoid arthritis – 2008☆

  • Tuulikki Sokka, MD, PhD

      Affiliations

    • Jyväskylä Central Hospital, 40620 Jyväskylä, Finland
    • Medcare Oy, Äänekoski, Finland
    • Corresponding Author InformationCorresponding author. Tel.: +358 40 735 2087; Fax: +358 14 2691 275.
    • ,
  • Heidi Mäkinen, MD

      Affiliations

    • Jyväskylä Central Hospital, 40620 Jyväskylä, Finland
    • Tampere University Hospital, Tampere, Finland

Modern therapy of rheumatoid arthritis (RA) is based on recognition of the severity of the natural history of disease, with early and aggressive treatment strategies. Methotrexate is the anchor drug, with addition of other disease-modifying anti-rheumatic drugs (DMARDs) in combinations, and biological targeted therapies. The approach emphasizes ‘tight control’, aiming for remission and low disease activity according to quantitative monitoring. In this chapter, we review selected randomized controlled studies for data concerning early versus delayed therapies. We present a historical perspective for the treatment of early RA using early RA cohorts from Finland as an example. Finally, we discuss principles of contemporary treatment of early RA in 2008.

Keywords: early rheumatoid arthritis, DMARDs, methotrexate

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☆ Modified and updated from: 1. Sokka T, Envalds M, Pincus T. Treatment of rheumatoid arthritis: a global perspective on the use of antirheumatic drugs. Mod Rheumatol. 2008 Apr 25. 2. Sokka T, Hannonen P, Möttönen T. Conventional disease-modifying antirheumatic drugs in early arthritis. Rheum Dis Clin North Am. 2005 Nov;31(4):729-44. Review.

PII: S1521-6942(08)00091-0

doi:10.1016/j.berh.2008.08.003

Best Practice & Research Clinical Rheumatology
Volume 23, Issue 1 , Pages 93-102, February 2009

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