Prognostic evaluation of early rheumatoid arthritis.
The progression of rheumatoid arthritis (RA) is quite variable, ranging from very mild or subclinical forms (approx. 10%) to rapidly progressing and debilitating forms (10-15%). The majority of patients present with an intermediate stage with episodes of exacerbation separated by periods of relative inactivity, which evolves to progressive functional losses. To optimise the therapeutic management of early RA it is necessary to perform periodic evaluations of the clinical and laboratory test responses to the treatment instituted, as well as the parameters indicating disease prognosis. Composite measures are frequently used to evaluate the disease activity score (DAS), including the response criteria of the American College of Rheumatology (ACR), the response criteria and the DAS according to the European League Against Rheumatism (EULAR) and the composite indices of disease activity (CIDsA): DAS, the index of disease activity based on 28 joints (DAS 28), the simplified disease activity index (SDAI) and the clinical disease activity index (CDAI). The evaluation of prognosis includes investigation of the absence or occurrence of disease and joint damage remission. Due to the multifaceted nature of RA, no single clinical or laboratory parameter is able to describe satisfactorily the level of inflammatory activity or the disease prognosis at any given time.
da Mota
Licia Maria Henrique
LM
Rheumatology Department of the Hospital Universitário de Brasília da Universidade de Brasília, Brasilia. licia@unb.br
Laurindo
Ieda Maria Magalhães
IM
de Carvalho
Jozélio Freire
JF
dos Santos-Neto
Leopoldo Luiz
LL
D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D004185:Disability Evaluation; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014463:Ultrasonography
D018501:Antirheumatic Agents