Predictive and potentially predictive factors in early arthritis: A multidisciplinary approach

P. Härle, T. Bongartz, J. Schölmerich, U. Müller-Ladner, R. H. Straub

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Objectives. Rheumatoid arthritis (RA) is characterized by variable degrees of joint inflammation, joint destruction, progressive disability and premature death. Destruction of joint cartilage and bone may occur early during disease, as was shown in longitudinal studies of RA, and there is increasing consent among rheumatologists that early diagnosis and early initiation of therapy with disease-modifying anti-rheumatic drugs (DMARDs) can limit the severity of RA. Unfortunately, the currently used diagnostic and predictive indicators (clinical, laboratory and radiological) are of limited value for making an early diagnosis and prognosis of the disease course at the individual level, thus reducing optimal benefit from present and emerging therapies. Therefore, this review focuses on the multidisciplinary aspects of neuroendocrine-immune changes in RA. Methods. A Medline search was performed using the search terms 'androgens', 'estrogens', 'sympathetic nervous system', 'sensory nervous system', 'prognosis', 'early rheumatoid arthritis', 'arthritis' and 'studies' in various combinations. For the tabular overview, we only listed clinical studies focusing on endocrine and neuronal aspects. Results. In addition to the currently used predictive indicators, there is an abundant body of literature describing changes of the neuronal, endocrine and immune parameters during inflammatory diseases. Unfortunately, no longitudinal studies concerning neuroendocrine aspects have been done up to now. Conclusion. Parameters of the neuroendocrine system should be included in anticipated longitudinal clinical studies to find their true predictive value in early RA.

Original languageEnglish (US)
Pages (from-to)426-433
Number of pages8
JournalRheumatology
Volume44
Issue number4
DOIs
StatePublished - Apr 1 2005

Keywords

  • Early rheumatoid arthritis
  • Endocrine system
  • Immune system
  • Nervous system
  • Prognosis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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    Härle, P., Bongartz, T., Schölmerich, J., Müller-Ladner, U., & Straub, R. H. (2005). Predictive and potentially predictive factors in early arthritis: A multidisciplinary approach. Rheumatology, 44(4), 426-433. https://doi.org/10.1093/rheumatology/keh530