title: Aspects of early arthritis. Biological therapy in early arthritis--overtreatment or the way to go?
abstract: The availability of newer, and more expensive, therapies for patients with rheumatoid arthritis has changed treatment beyond recognition. Disease remission is the goal for all new patients. Studies have shown that a combination of tumour necrosis factor (TNF)-blocking drugs and methotrexate produces superior outcomes over monotherapy alone; however, use is limited by cost and potential side-effects. Currently, anti-TNF therapy is normally reserved for patients who have failed traditional disease-modifying anti-rheumatic drugs. The question that remains is whether TNF-blocking drugs are better used if given early; the high direct costs are countered by both direct and indirect savings in healthcare costs from optimal control of disease, and the benefits of early control outweigh the increased risk of infection and malignancy.
authors.affiliation: Academic Unit of Musculoskeletal Disease, Leeds University, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK.
authors.forename: Kei
authors.initials: K
authors.lastname: Ikeda
authors.forename: Sally
authors.initials: S
authors.lastname: Cox
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D042241:Early Diagnosis; D006801:Humans; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000187:drug effects
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha