Rheumatoid polyarthritis: therapeutic management

AN OPEN QUESTION: Developing a therapeutic strategy for rheumatoid arthritis is a difficult and much debated task. Recent clinical trials have confirmed the importance of initiating treatment at the onset of disease in all patients with rheumatoid arthritis in order to limit the degree of later progression. INDIVIDUALIZED REGIMENS: Treatment for patients with early-stage rheumatoid arthritis should be adapted individually taking into consideration the expected benefit and risks of drug therapy, the degree of joint inflammation and factors predictive of disease severity which are becoming more and more well understood. PATIENTS IN REMISSION: Treatment should be continued if well tolerated. Treatment should not be discontinued (and then only progressively) unless complete remission has been achieved for a long period. LONG-STANDING DISEASE: The precise therapeutic strategy in patients with long-standing disease remains a question of debate, but does require full-dose combination regimens.