Concept of Rheumatoid Arthritis (RA)

Rheumatoid arthritis is a chronic inflammatory joint disease that can cause cartilage and bone damage as well as disability. Early diagnosis is the key to optimal therapeutic success, particularly in patients with well-characterized risk factors for poor outcome such as high disease activity, presence of autoantibodies, and early joint damage. Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects the lining of synovial joints and is associated with progressive disability, premature death and socioeconomic burden. There is an urgent need for a better understanding of how pathological mechanisms drive the slowdown of RA progression in individuals in order to develop therapies that effectively treat patients at each stage of disease progression. Here we divide the etiology and pathology into specific stages triggering, (ii) maturation, (iii) targeting, and (iv) fulminant stage, concomitant with hyperplastic synovial, cartilage damage, bone erosion, and systemic consequences. Modern pharmacologic therapies (including conventional, biological, and novel potential small molecule disease-modifying anti-rheumatic drugs) remain the mainstay of RA treatment and there has been significant progress toward achieving disease remission without joint deformity. Despite this, a significant proportion of RA patients do not effectively respond to the current therapies and thus new drugs are urgently required. This review discusses recent advances of our understanding of RA pathogenesis, disease modifying drugs, and provides perspectives on next generation therapeutics for RA.