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Targeting early disease: lessons from rheumatoid arthritis

Although there seem to be few similarities between IBD and rheumatoid arthritis (RA), lessons may be learned from how rheumatologists target early disease. A specific characteristic of musculoskeletal disease such as RA is its destructive effect. This gives way to an early preventive treatment, as timely intervention can change the course of the disease. Structural progression is different in early vs. very early treatment and early effective treatment affects long-term outcomes of RA [17,18].

A problem frequently encountered in RA is the delay in assessment; this has a negative impact on early treatment and subsequent outcomes. A trial by Van Aken et al. with methotrexate in pre-RA showed it somewhat delays the onset vs. placebo, but not significantly [19]. When the (small) study population was separated into two groups (serologic positive and negative), there was, however, a clear difference. Thus, serology might be an indicator for early diagnosis and...

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