¿Por qué un tratamiento precoz en la artritis reumatoide?

Abstract

Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation of diarthrodial joints, which may also cause involment of other organs. Today, most authors agree that nearly 80% of the patients will present with some degree of disability after 10 years evolution. Prognosis of rheumatoid arthritis is uncertain, and lesions, that are produced in the first years of the disease, may progress despite clinical improvement, since pathogenesis of these lesions may differ from simple acute joint inflammation. Early diagnosis is therefore essential in order to start treatment before structural joint damage develops, since there is evidence that patients treated during the first year from the beginning of symptoms present better functional capacity outcome than those treated later. Classic treatment for this disease had been based, until recently, on the traditional therapeutic pyramid which consisted in sequential introduction of drugs. Poor results of this strategy and awareness of the bad prognosis of the disease has demanded a reevaluation of its therapeutic approach. In this sense, introduction of remission induction agents early in the course of the disease seems appropiate, with the aim of reducing morbidity and functional disability.