Long-term outcomes in rheumatoid arthritis.

Long-term outcomes in the majority of patients with established rheumatoid arthritis (RA) include radiographic progression, severe functional declines, work disability and premature mortality. These outcomes have been recognized primarily in long-term clinical observational studies, which also indicate that most courses of traditional therapies are discontinued within 2 yr. Severe long-term outcomes in RA are predicted more effectively by sustained inflammatory activity than by any measure of baseline activity at a single point in time. Aggressive efforts to control inflammatory activity prior to irreversible damage would appear to be a reasonable strategy for treatment of RA.