Recent advances in rheumatoid arthritis and other arthropathies

Abstract

Over the last 25 years, rheumatology has seen a huge expansion in agents available to treat inflammatory joint diseases, including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, as well as osteoarthritis and autoimmune rheumatic diseases such as systemic lupus erythematosus. These therapeutic advances have evolved through our deeper understanding of the pathogenesis of immune pathways and the interplay of omics, as well as realization of the heterogeneity within single phenotypes. We now have the real prospect of being able to offer patients remission, and in some, drug-free remission. This article discusses these advances and the challenges, in terms of disease interception, diagnosis and imaging, novel therapeutic approaches, the role of precision medicine, the influence of the menopause in rheumatic symptoms, managing comorbidities, as well as peri-operative issues for patients who require disease-modifying anti-rheumatic medications.