From the Guidelines
Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis, and its management involves a treat-to-target approach with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX) as the first-line treatment. According to the European League Against Rheumatism (EULAR) recommendations, updated in 2016 1, MTX should be started at a dose that can be rapidly escalated to 25 mg/week, in combination with short-term glucocorticoids (GC), aiming for more than 50% improvement within 3 months and target attainment within 6 months.
Key Characteristics of Autoimmune Arthritis
- Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects the small joints symmetrically
- Other types of autoimmune arthritis include psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE), juvenile idiopathic arthritis, and reactive arthritis
- Treatment strategies for autoimmune arthritis focus on reducing inflammation, relieving symptoms, and preventing joint damage
Treatment Approaches
- Disease-modifying antirheumatic drugs (DMARDs) such as MTX, leflunomide, and sulfasalazine are commonly used to treat autoimmune arthritis
- Biologic DMARDs, including tumor necrosis factor (TNF) inhibitors (e.g., adalimumab, etanercept) and Janus kinase (JAK) inhibitors (e.g., tofacitinib, baricitinib), may be added to the treatment regimen if the patient does not respond to conventional synthetic DMARDs
- Glucocorticoids (GC) may be used for short-term relief of symptoms and to reduce inflammation during flare-ups, as recommended by the EULAR guidelines 1
Importance of Early Diagnosis and Treatment
- Early diagnosis and treatment of autoimmune arthritis are crucial to prevent joint damage and disability
- A treat-to-target approach, as recommended by the EULAR guidelines 1, can help achieve sustained clinical remission or low disease activity, improving the patient's quality of life and reducing morbidity and mortality.
From the FDA Drug Label
B cells are believed to play a role in the pathogenesis of rheumatoid arthritis (RA) and associated chronic synovitis. In this setting, B cells may be acting at multiple sites in the autoimmune/inflammatory process, including through production of rheumatoid factor (RF) and other autoantibodies, antigen presentation, T-cell activation, and/or proinflammatory cytokine production.
The type of autoimmune arthritis is Rheumatoid Arthritis (RA) 2.
- Key points:
- B cells play a role in the pathogenesis of RA
- RA is an autoimmune/inflammatory process
- B cells may produce rheumatoid factor (RF) and other autoantibodies, present antigens, activate T-cells, and produce proinflammatory cytokines.
From the Research
Types of Autoimmune Arthritis
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by unresolved synovial inflammation, which can lead to tissue destruction and disability 3.
- RA is primarily characterized by synovitis, accompanied by extra-articular organ involvement, and clinical symptoms such as pain, swelling, stiffness of multiple joints, fever, and malaise 4.
- The disease can progress to joint destruction and irreversible physical dysfunction if left untreated or not properly managed 4, 5.
Characteristics of Rheumatoid Arthritis
- RA is an autoimmune inflammatory disease that affects about 0.2-1% of the global population 3.
- The disease is characterized by immunological and inflammatory changes, which can occur even before the development of clinical symptoms 5.
- RA can be managed with disease-modifying antirheumatic drugs (DMARDs), which can help control inflammation and decrease bone destruction 4, 6.
Treatment Options for Rheumatoid Arthritis
- Combination therapy with methotrexate and other DMARDs, such as sulfasalazine and hydroxychloroquine, can be effective in controlling disease activity and preventing joint damage 7, 6.
- Biologic DMARDs, such as abatacept, adalimumab, and etanercept, can also be used to treat RA, especially in patients who do not respond to conventional DMARDs 6.
- Targeted synthetic DMARDs, such as tofacitinib, can also be used to treat RA, and have been shown to be effective in controlling disease activity and preventing joint damage 6.