Comprehending the symptomatic phase preceding rheumatoid arthritis: Clinically suspect arthralgia

Abstract

This thesis focused on investigating the early identification of Rheumatoid Arthritis (RA), assessing the burden of disease, and enhancing understanding of disease mechanisms in the earliest disease phases. Many of the studies in this thesis focused on data from the Leiden Clinically Suspect Arthralgia (CSA) cohort. The CSA cohort is an inception cohort at the rheumatology outpatient clinic of the Leiden University Medical Centre, in Leiden, the Netherlands. CSA patients had recent-onset (

We showed that although early identification is increasingly improving, there remains a large proportion of patients that cannot be accurately identified despite a suspect pattern of signs and symptoms, as well as information on autoantibodies. Furthermore, the burden of disease is already substantial during the symptomatic pre-arthritis phase of CSA. Future studies will have to provide evidence for the effectiveness of preventing persistent RA and functional disability with prescribing Disease-modifying antirheumatic drugs (DMARD) treatment in the phase of CSA.