Abstract

ADVANCEMENTS IN RHEUMATOID ARTHRITIS MANAGEMENT: A COMPREHENSIVE REVIEW OF EARLY DIAGNOSIS AND TREATMENT STRATEGIES

Poorana Pushkalai S.* and Gayathiri N. M.

ABSTRACT

Rheumatoid arthritis (RA) affects approximately 5 per 1000 individuals and can lead to severe joint damage and disability. Recent decades have seen significant progress in understanding its pathophysiology, optimal outcome measures, and treatment strategies. Early diagnosis and treatment are crucial, with up to 90% of patients benefiting from timely intervention, which can prevent irreversible disability. Novel instruments for measuring disease activity have enabled the development of new treatment approaches to halt RA progression before irreversible joint damage occurs. Methotrexate, in combination with glucocorticoids, is the first-line therapy, with remission or low disease activity achievable in 40% to 50% of patients. Sequential use of targeted therapies, including biologic agents like TNF inhibitors, has further improved outcomes, with up to 75% of patients reaching treatment targets over time. The advent of biosimilar drugs has also helped reduce the costs associated with therapy. By
adopting a treat-to-target strategy, focused on reducing disease activity within 3 months and achieving remission or low disease activity within 6 months, RA-related disability can be prevented, highlighting the importance of early and aggressive intervention.

Keywords: Rheumatoid arthritis, Disease progression, Treatment strategies, Disease-modifying anti-rheumatic drugs (DMARDs), inflammatory joint disease.