A new window of opportunity in rheumatoid arthritis

Abstract

Purpose of review -Progress in our understanding of the preclinical events in rheumatoid arthritis (RA) has provided important insights into disease pathogenesis. Studying prospective cohorts of individuals at risk for RA development offers the opportunity to accurately characterise the sequence of events in preclinical disease as well as quantify the risk of different preclinical phenotypes. These data may provide the basis for preventive strategies in RA.

Certolizumab Pegol in a Heterogeneous Population of Patients with Moderate-To-Severe Rheumatoid Arthritis

“…RA-related systemic autoimmune and inflammatory events occur well before clinical RA. Thus, multiple biomarkers are under study to achieve identification of individuals at risk of RA in general population [ 43 ]. Biomarkers can be related to RA phenotypes.…”

“…There is a trend to personalized RA risk assessment using genetics, biomarkers and lifestyle factors [ 45 ]. RA prevention will not be based only in lifestyle changes, because immunomodulators are under study for use in individuals with high risk of RA development [ 43 ].…”

The 2016 Eular Guidelines for the Diagnosis and Treatment of Early Arthritis

“…Речь идет о возможности замедления или даже предотвращении трансформации раннего артрита в РА, т. е. фактически о вторичной профи-лактике РА [122][123][124][125] (табл. 3).…”

How Are Rheumatologists Managing Anticyclic Citrullinated Peptide Antibodies–positive Patients Who Do Not Have Arthritis?

“…This presents a clinical problem but also a significant opportunity. There is no evidence for the management of these (often symptomatic) at-risk individuals, but it is possible that the right intervention in this phase may prevent clinical arthritis 5,6 . This hypothesis is being explored in clinical trials (e.g., rituximab delayed, but did not prevent, arthritis onset in at-risk individuals) 7 .…”