Evaluation and medical management of end-stage rheumatoid arthritis
- Simon M Helfgott, MD
Simon M Helfgott, MD
- Associate Professor of Medicine
- Harvard Medical School
- Section Editor
- Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
- Section Editor — Rheumatoid Arthritis
- Emeritus Professor of Rheumatology, Imperial College London
- Visiting Professor, Oxford University
Despite the availability of methotrexate (MTX), other disease-modifying antirheumatic drugs (DMARDs), and biologic agents, some patients with rheumatoid arthritis (RA) fail to adequately respond to therapy . Via a variety of mechanisms, the joints of such patients may eventually be destroyed, requiring joint arthroplasty to restore function.
This stage of the disease, termed “end-stage RA,” is characterized clinically by the following features:
●Pain occurring with minimal activity and at rest
●Periarticular muscle atrophy and weakness
●A significant decline in functional status resulting in disability
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