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Evaluation and medical management of end-stage rheumatoid arthritis

Simon M Helfgott, MD
Section Editor
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Deputy Editor
Paul L Romain, MD


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 [1]. 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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Literature review current through: Sep 2016. | This topic last updated: Mar 22, 2016.
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