Rheumatoid arthritis: pathophysiology, diagnosis and treatment

Abstract

Rheumatoid arthritis is a disease associated with breaking of immune tolerance and may be related to age and sex of individual. Prognosis is associated with positive early detection of disease, the diagnosis depends on the association of a series of clinical symptoms and signs, laboratory findings and radiographic involving clinical and laboratory criteria. The chronic stage leads to serious damage, including joint deformities, for control of pain and inflammatory joint use of NSAIDs, alone or combined with low-dose glucocorticoids, there is always the need to individualize the therapy according to risk factors for each patient, recently incorporated to the therapeutic armamentarium of RA, biologicals have proven effective in combination with methotrexate. Are indicated in moderate to severe RA that has not responded to other DLA, are available commercially in Brazil agents biological response modifiers such as TNF blockers (adalimumab, etanercept and infliximab), depleting B-lymphocytes (rituximab) and modulators co-stimulation: abatacept, and in some cases surgical treatment is indicated when there is no response to other treatments. However understanding the evolution and activation of AR (pathophysiology) was necessary for better medical intervention in seeking treatment and change the course of the disease, diagnostic criteria are well defined and treatments in the chronic stage of the disease showed technical advance and scientific, but the data were conclusive that there is a need for further research to establish parameters not yet widespread.