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Aggressive drug therapy for rheumatoid arthritis
1Stanford University School of Medicine.
Hospital Practice (Office Ed.)
|September 15, 1993
Summary
Rheumatoid arthritis is a severe, progressive disease that can shorten life expectancy. Early, aggressive treatment with disease-modifying antirheumatic drugs may be necessary if initial therapies fail.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is increasingly recognized as a systemic, progressive, and disabling condition.
- Emerging data suggest RA significantly impacts patient life expectancy.
- This necessitates a re-evaluation of current RA management strategies.
Purpose of the Study:
- To highlight the progressive nature of rheumatoid arthritis.
- To advocate for a shift towards more aggressive pharmacologic management in RA.
- To inform clinical decision-making regarding RA treatment escalation.
Main Methods:
- Review of recent data on rheumatoid arthritis progression and outcomes.
- Analysis of the impact of RA on life expectancy.
- Evaluation of treatment response to conservative versus aggressive therapies.
Main Results:
- Rheumatoid arthritis is frequently systemic, progressive, and disabling.
- RA is associated with a reduced life expectancy.
- Conservative treatments (rest, exercise, anti-inflammatories) may be insufficient for many patients.
Conclusions:
- A dramatic alteration in the pharmacologic management of rheumatoid arthritis is warranted.
- Aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) and immunosuppressive agents should be considered.
- Escalation of therapy is indicated when initial management proves ineffectual over several months.