Josef S Smolen1, Daniel Aletaha. 1. Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Austria. josef.smolen@meduniwien.ac.at
Abstract
PURPOSE OF REVIEW: The approach to treating rheumatoid arthritis has changed over the last decade not only because of new therapeutic agents but also because of new treatment strategies. These strategies involve aiming at a treatment target, usually remission or low disease activity and monitoring patients regularly to attain this goal. Here we review the most recent insights related to monitoring of rheumatoid arthritis. RECENT FINDINGS: New insights were gained into the advantages and limitations of patient global assessment of disease severity and self-reported joint counts. The stringency of defining remission by the simplified disease activity index when compared with other instruments was confirmed by ultrasonography. Sensitivity to change and similarity to clinical assessments were shown for ultrasonographic indices; a simplified score for assessing joint damage by magnetic resonance imaging was presented. Physical function and working capacity continue to be impaired in the most recent decade. The evidence-based treat-to-target recommendations, developed by an international task force, are means to improve this situation. The American College of Rheumatology and the European League Against Rheumatism have most recently developed a stringent definition of remission for trials and practice. SUMMARY: The recent data provide compelling evidence for the importance of monitoring to attain the treatment targets in rheumatoid arthritis.
PURPOSE OF REVIEW: The approach to treating rheumatoid arthritis has changed over the last decade not only because of new therapeutic agents but also because of new treatment strategies. These strategies involve aiming at a treatment target, usually remission or low disease activity and monitoring patients regularly to attain this goal. Here we review the most recent insights related to monitoring of rheumatoid arthritis. RECENT FINDINGS: New insights were gained into the advantages and limitations of patient global assessment of disease severity and self-reported joint counts. The stringency of defining remission by the simplified disease activity index when compared with other instruments was confirmed by ultrasonography. Sensitivity to change and similarity to clinical assessments were shown for ultrasonographic indices; a simplified score for assessing joint damage by magnetic resonance imaging was presented. Physical function and working capacity continue to be impaired in the most recent decade. The evidence-based treat-to-target recommendations, developed by an international task force, are means to improve this situation. The American College of Rheumatology and the European League Against Rheumatism have most recently developed a stringent definition of remission for trials and practice. SUMMARY: The recent data provide compelling evidence for the importance of monitoring to attain the treatment targets in rheumatoid arthritis.
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