[New therapeutic strategy of rheumatoid arthritis to reach the goal of suppression of joint destruction].

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis and bone damages, which consist of joint destruction. The pathogenesis of RA is not well understood, but molecular events leading to tissue inflammation with cartilage and bone destruction are now defined in more detail. Previous therapy, slow acting disease-modifying antirheumatic drugs (DMARDs) as with low-dose methotrexate (MTX) were accepted for RA and lead to a significant improvement of disease symptoms, however were unable to stop joint destruction. Recently therapeutic strategies using biologics including infliximab and etaner-cept are effective for treating RA disease activity and reduce joint destruction. Moreover it has been shown that disability and joint destruction occur early in the course of RA and progress rapidly. These findings support the hypothesis "window of opportunity for therapeutic intervention in RA" , and the aggressive therapy early in the course of RA is expected to result in the induction of remission or, perhaps most important, a chance of cure.