Review article

Clinical approach to a patient with rheumatoid arthritis

Dijana Perković ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Dušanka Martinović Kaliterna ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Daniela Marasović Krstulović ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Ivona Božić ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Katarina Borić ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Mislav Radić ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia

Abstract

Rheumatoid arthritis (RA) is chronic inflammatory rheumatic disease which leads to joint damage, functional impairment and reduced quality of life. The disease should be recognized early when there is a “window of opportunity” to apply adequate treatment which may prevent structural damage. As clinical presentation of RA is not always typical, great knowledge and clinical experience, including collaboration of rheumatologist, general practitioner and patient, are required. The treatment should be started immediately upon the diagnosis, while the choice of modality of treatment depends on the rheumatologist in accordance with the patient. The RA patients with the higher risk of aggressive disease need to be recognized because they require more aggressive treatment from the start. The goal of the treatment is remission or at least low disease activity. Current treatment of RA includes disease modifying antirheumatic drugs (DMARDs) synthetics and biologics, nonsteroidal antirheumatic drugs (NSAIDs), glucocorticoids, analgesics, and rarely cytostatics. The course of disease is usually fluctuating with the exchange of relapses and remissions. Recognition of the relapsing patient on time enables treatment intensification or modifications in treatment scheme. Special issue in RA represents glucocorticoid-induced osteoporosis (GIO) which should be prevented by usage of calcium and vitamin D supplements and treated by antiresorptive or osteoanabolic agents. Besides the treatment of the primary disease, the care of RA patients should consider comorbidities, side effects of treatment, complications of disease, and psychosocial aspects of chronic disease.

Keywords

rheumatoid arthritis; clinical approach; early diagnosis; multidisciplinary care

Hrčak ID:

137893

URI

https://hrcak.srce.hr/137893

Publication date:

23.10.2014.

Article data in other languages: croatian

Visits: 7.559 *