Characteristics of and treatment strategies for preclinical rheumatoid arthritis

Rheumatoid arthritis, characterized by persistent inflammation and joint damage, affects 1% of the world's population. Several studies have shown that early treatment can reduce the severity of disease progression and increase the chances of sustained remission without disease-modifying antirheumatic drugs. Recent research data indicate that the disease process has been active in the pre-clinical stage (before arthritis can be detected clinically). However, it is not clear when RA will begin. This article reviews the latest advances in this field, explores the characteristics of pre-RA, identifies pre-clinical patients who may develop into RA, and discusses the limitations of our current understanding of pre-RA and the possible future research directions. Key words: Rheumatoid arthritis; Preclinical stage; Arthralgia; Autoantibodies