Towards improved treatment of undifferentiated and rheumatoid arthritis

Visser, K. (2011)

Doctoral Thesis

Major advances have been made in the treatment of rheumatoid arthritis, a potentially chronic disabling disease which poses a large burden on both patients and society. By early start of disease-modifying antirheumatic drugs, including methotrexate as a prominent drug, the use of combination therapies including prednisone or biologicals, and tight control of disease activity, many patients are able to reach a state of clinical remission and some can even taper and stop antirheumatic therapy. Challenges lie in correctly identifying the earliest manifestations of the disease, starting the right treatment sufficiently early, tailored to the individual patient, and setting the optimal treatment goal at which to steer therapy adjustments. This thesis has made a start towards tackling several of these challenges and discusses further necessary steps that may lead to a fundamental change in the outlook of patients with rheumatoid arthritis.

• Undifferentiated arthritis
• Systematic review
• Rheumatoid arthritis
• Joint damage
• Treatment
• Prediction
• Methotrexate

• All authors: Visser, K.
• Supervisor: Huizinga, T.W.J.; Heijde, D.M.F.M. van der
• Co-supervisor: Allaart, C.F.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2011-12-08
• ISBN (print): 9789081828109
• Sponsorship: Dutch College of Health Insurances, Dutch Arthritis Foundation Netherlands Organisation for Scientific Research Schering-Plough B.V., Centocor Inc and ABBOTT B.V.