A new era in rheumatoid arthritis treatment-time to introduce a modified treatment pyramid

摘要

the traditional stepped-up therapy in rheumatoid arthritis (RA)-prescribing non-steroidal anti- inflammatory drugs (NSAIDs) for a long time and only eventually adding a second-line agent (the so- called/pyramid') has long been abandoned, and for very good reasons. Several important insights have been gained in recent years which have led to an entirely different approach to RA treatment. First, long-term studies of the natural history and out- comes of large cohorts of RA patients have revealed that RA is not the benign disease it was once considered to be.