title: Early combination disease modifying antirheumatic drug treatment for rheumatoid arthritis.
abstract: Most people presenting with rheumatoid arthritis today can expect to achieve disease suppression, can avoid or substantially delay joint damage and deformities, and can maintain a good quality of life. Optimal management requires early diagnosis and treatment, usually with combinations of conventional disease modifying antirheumatic drugs (DMARDs). If these do not effect remission, biological DMARDs may be beneficial. Lack of recognition of the early signs of rheumatoid arthritis, ignorance of the benefits of early application of modern treatment regimens, and avoidable delays in securing specialist appointments may hinder achievement of best outcomes for many patients. Triage for recognising possible early rheumatoid arthritis must begin in primary care settings with the following pattern of presentation as a guide: involvement of three or more joints; early-morning joint stiffness of greater than 30 minutes; or bilateral squeeze tenderness at metacarpophalangeal or metatarsophalangeal joints.
authors.affiliation: Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia. lyndenr@unimelb.edu.au
authors.forename: Lynden J
authors.initials: LJ
authors.lastname: Roberts
authors.forename: Leslie G
authors.initials: LG
authors.lastname: Cleland
authors.forename: Ranjeny
authors.initials: R
authors.lastname: Thomas
authors.forename: Susanna M
authors.initials: SM
authors.lastname: Proudman
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D006801:Humans
chemical_list: D018501:Antirheumatic Agents