DEFINITION

Larry W. Moreland, Rayford R. June

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder that is characterized by symmetrical joint pain and swelling, morning stiffness, and fatigue. RA has a variable disease course, often with periods of exacerbations and, less frequently, disease quiescence. Outcomes range from rarely seen remitting disease to severe disease that produces disability and, for some patients, premature death.

Without treatment, most patients have progressive joint damage and significant disability within a few years. Since the introduction of methotrexate in 1985 and tumor necrosis factor-α (TNF-α) inhibitors in the 1990s, there has been a change in the treatment paradigm; many conventional and biologic therapies are now available to effectively treat this previously debilitating chronic disease.