Microsoft excel 2011 update 14.6.7
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As a consequence, comparing patients withestablished RA from previous decades to contemporary patients diagnosed in recent years lacks face validity. In 2021, we now treat RA more aggressively, and the clinical outcomes are much improved. Most evidence is derived from people with well-established disease and a substantial burden of comorbidities. There is little evidence available that specifically considers the safety of treatments for early RA.
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Potential side effects must therefore be taken into consideration when commencing treatments in patients with RA. Patients with RA have increased morbidity and mortality relative to that of the general population, and RA associates with multiple comorbidities, including diabetes, infections and cardiovascular diseases. The introduction of treat-to-target (T2T) strategies optimized outcomes for patients, with disease activity guiding adjustments in treatment with conventional synthetic DMARDs (csDMARDs), biologic DMARDs (bDMARDs), targeted synthetic DMARDs (tsDMARDs) and CSs. The historic approach to treating newly diagnosed RA involved bed rest, analgesia, and (subsequently) DMARDS. Without adequate treatment, RA can lead to severe joint deformity and disability, impacting upon patients’ quality of life and work ability. It is characterized by chronic joint inflammation, synovial hyperplasia and systemic manifestations. Steroid-based treatment strategies did not emerge as more harmful in early RA compared to established RA. For the typical early RA patient, few differences exist between treatments strategies in terms of risk profile.