While waiting for my next consultation, I've been reading the medical literature on the diagnosis and treatment of inflammatory arthritis and created a small review. It's fantastic to be able to access scientific literature free online, albeit abstracts only for the BMJ. Fortunately medical abstracts are comprehensive and seem to be written to a fairly consistent format.
The review did not exactly put a spring in my step:
- the disease is not curable, at best you can hope for its progression to be slowed or stopped
- treatment with NSAIDs has been phased out in favour of DMARDs
- the efficacy of the most commonly used DMARD, methotrexate is debatable
- recent results show that tumour necrosis factor (TNF) inhibitors are more effective than methotrexate but because they're far more costly are only likely to be prescribed if methotrexate fails
- it's important to start treatment early in the course of the disease, a so-called therapeutic window of opportunity
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