1. Extra-articular manifestations of rheumatoid arthritis: An update.
- Author
-
Prete M, Racanelli V, Digiglio L, Vacca A, Dammacco F, and Perosa F
- Subjects
- Amyloidosis drug therapy, Amyloidosis immunology, Amyloidosis mortality, Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid immunology, Arthritis, Rheumatoid mortality, Cardiovascular Diseases drug therapy, Cardiovascular Diseases immunology, Cardiovascular Diseases mortality, Clinical Trials as Topic, Comorbidity, Europe epidemiology, Humans, Incidence, Inflammation drug therapy, Inflammation immunology, Inflammation mortality, Joints drug effects, Joints immunology, Joints pathology, Kidney drug effects, Kidney immunology, Kidney pathology, Lung drug effects, Lung immunology, Lung pathology, Myocardium immunology, Myocardium pathology, Neoplasms drug therapy, Neoplasms immunology, Neoplasms mortality, Nervous System drug effects, Nervous System immunology, Nervous System pathology, Severity of Illness Index, Skin drug effects, Skin immunology, Skin pathology, Splenomegaly drug therapy, Splenomegaly immunology, Splenomegaly mortality, Survival Rate, Turkey epidemiology, United States epidemiology, Amyloidosis pathology, Arthritis, Rheumatoid pathology, Cardiovascular Diseases pathology, Inflammation pathology, Neoplasms pathology, Splenomegaly pathology
- Abstract
Rheumatoid arthritis (RA) is an immune-mediated disease involving chronic low-grade inflammation that may progressively lead to joint destruction, deformity, disability and even death. Despite its predominant osteoarticular and periarticular manifestations, RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations (EAM). Despite the fact that EAM have been studied in numerous RA cohorts, there is no uniformity in their definition or classification. This paper reviews current knowledge about EAM in terms of frequency, clinical aspects and current therapeutic approaches. In an initial attempt at a classification, we separated EAM from RA co-morbidities and from general, constitutional manifestations of systemic inflammation. Moreover, we distinguished EAM into cutaneous and visceral forms, both severe and not severe. In aggregated data from 12 large RA cohorts, patients with EAM, especially the severe forms, were found to have greater co-morbidity and mortality than patients without EAM. Understanding the complexity of EAM and their management remains a challenge for clinicians, especially since the effectiveness of drug therapy on EAM has not been systematically evaluated in randomized clinical trials., (Copyright © 2011 Elsevier B.V. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF