Rheumatoid arthritis is a common chronic inflammatory and destructive arthropathy that cannot be cured and that has substantial personal, social, and economic costs. The long term prognosis is poor: 80 percent of affected patients are disabled after 20 years, and life expectancy is reduced by an average of 3 to 18 years. The medical cost of rheumatoid arthritis averages $5,919 per case per year in the United States and approximately L2,600 per cased per year in the United Kingdom. Current slow acting antirheumatic drugs have limited efficacy and many side effects. Moreover, they do not improve the long term prognosis of rheumatoid arthritis. The inflammatory process is usually tightly regulated, involving both mediators that initiate and maintain inflammation and mediators that shut the process down. In states of chronic inflammation, an imbalance between the two mediators leaves inflammation unchecked, resulting in cellular damage. In the case of rheumatoid arthritis, this damage is manifested by the destruction of cartilage and bone.
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