New insights into the pathogenesis and management of rheumatoid arthritis.

ABSTRACT

Over the past few decades, understanding of the pathogenesis of rheumatoid arthritis (RA) has improved substantially. Insights into the cellular and molecular mechanisms involved in RA have enabled the discovery of new therapeutic targets and led to the development of biologics and targeted synthetic disease-modifying antirheumatic drugs. In parallel with the improvement in therapies, the evolution of strategies in the management of RA has also contributed considerably to better outcomes in patients. Major changes include the development of disease activity measures, formulation of the treat-to-target principles as well as increased attention to comorbidities. The presence of comorbidities such as cardiovascular diseases may increase the mortality of RA patients, affect their treatment strategies and result in worse outcomes. Therefore, prevention and management of certain high-risk comorbidities have become increasingly important in the long-term treatment of RA. In this study, we summarized new insights into the pathogenesis and management of rheumatoid arthritis and associated comorbidities, with a special focus on the 2021 update of the American College of Rheumatology (ACR) guideline for RA and key reports presented at the 2021 ACR convergence.