Window of opportunity in early rheumatoid arthritis: possibility of altering the disease process with early intervention.

Therapeutic strategies for the treatment of rheumatoid arthritis (RA) have changed significantly in the last decade. The emphasis is now on early intervention with the aim of preventing disability and irreversible damage. Advocates of early intervention would suggest an alteration in the disease process, not just debulking of inflammatory disease. The data would at least support attenuation of the disease process with aggressive early therapy. Further research is required to elucidate the scientific mechanisms involved and their impact on the pathological progress of RA.