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