Towards preventive treatment of rheumatoid arthritis

Prevention of rheumatoid arthritis is an ambitious therapeutic goal. Once it has developed, rheumatoid arthritis is characterised by high chronicity and often requires lifelong treatment.1,2 Sustained drug-free remission is rare, especially in seropositive disease, which is defined by the presence of rheumatoid factor and anti-citrullinated protein antibodies (ACPA).3 Onset of rheumatoid arthritis, characterised by joint swelling, is preceded by a pre-arthritis phase, in which patients show discrete symptoms (eg, pain), presence of autoantibodies (rheumatoid factor and ACPA), and subclinical signs of inflammation (eg, tenosynovitis) on an ultrasound or MRI scan.