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Abstract
Early diagnosis and prompt treatment can improve outcomes in rheumatoid arthritis
(RA). Significant joint damage occurs early in the course of the disease, when RA
is most aggressive. Many rheumatologists now advocate an inverted pyramid approach
to therapy, in which treatment with disease-modifying antirheumatic drugs is initiated
on diagnosis. The goals of this approach are to preserve patient function and to slow
disease progression. Current therapies exhibit varying degrees of efficacy and cumulative
toxicity that frequently limit their usefulness, particularly with long-term use.
New biologic response modifiers (BRMs) that target specific cells or cytokines involved
in the inflammatory response hold great promise for RA therapy because of their improved
efficacy and limited toxicity. The first BRM to be approved by the US Food and Drug
Administration for use in RA is etanercept, a soluble tumor necrosis factor-receptor
fusion protein. Etanercept is highly effective in relieving RA symptoms and has a
good safety profile. The availability of welltolerated therapies may encourage clinicians
to diagnose and treat RA more promptly, thereby ensuring patients the best possible
outcomes.
Key words
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Article info
Publication history
Accepted:
July 13,
1999
Identification
Copyright
© 1999 Published by Elsevier Inc.
