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Rheumatoid arthritis
Author(s):
David L Scott
,
Frederick Wolfe
,
Tom WJ Huizinga
Publication date
Created:
September 2010
Publication date
(Print):
September 2010
Journal:
The Lancet
Publisher:
Elsevier BV
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Abstract
Rheumatoid arthritis is characterised by persistent synovitis, systemic inflammation, and autoantibodies (particularly to rheumatoid factor and citrullinated peptide). 50% of the risk for development of rheumatoid arthritis is attributable to genetic factors. Smoking is the main environmental risk. In industrialised countries, rheumatoid arthritis affects 0·5-1·0% of adults, with 5-50 per 100 000 new cases annually. The disorder is most typical in women and elderly people. Uncontrolled active rheumatoid arthritis causes joint damage, disability, decreased quality of life, and cardiovascular and other comorbidities. Disease-modifying antirheumatic drugs (DMARDs), the key therapeutic agents, reduce synovitis and systemic inflammation and improve function. The leading DMARD is methotrexate, which can be combined with other drugs of this type. Biological agents are used when arthritis is uncontrolled or toxic effects arise with DMARDs. Tumour necrosis factor inhibitors were the first biological agents, followed by abatacept, rituximab, and tocilizumab. Infections and high costs restrict prescription of biological agents. Long-term remission induced by intensive, short-term treatment selected by biomarker profiles is the ultimate goal. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Journal
Title:
The Lancet
Abbreviated Title:
The Lancet
Publisher:
Elsevier BV
ISSN (Print):
01406736
Publication date Created:
September 2010
Publication date (Print):
September 2010
Volume
: 376
Issue
: 9746
Pages
: 1094-1108
Article
DOI:
10.1016/S0140-6736(10)60826-4
PubMed ID:
20870100
SO-VID:
5a06d197-d2f6-4a06-944e-1f723a605aff
Copyright ©
© 2010
License:
https://www.elsevier.com/tdm/userlicense/1.0/
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