Early arthritis therapy: rationale and current approach.

Rheumatoid arthritis (RA) is a disease that seriously affects patients' quality of life and may lead to disability or even premature death, despite the availability of effective treatments. Evidence suggests that delay of treatment may be the main contributing factor for poor outcome. Delay is caused primarily by the erroneous belief that the course of RA may be controlled in many cases by mild measures such as nonsteroidal antiinflammatory drugs, physiotherapy, and rest. While this may be true in a certain percentage of patients, many patients with RA progress to severe disability. To prevent progression of disease, early treatment of RA, particularly in patients at high risk, seems mandatory. Therefore, early arthritis clinics (EAC) have been established in a number of countries. We discuss the rationale for early intervention and our experiences in Austrian EAC.