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Challenges and opportunities in the early diagnosis and optimal management of rheumatoid arthritis in A frica and the M iddle E ast

2014; Wiley; Volume: 18; Issue: 3 Linguagem: Inglês

10.1111/1756-185x.12320

1756-185X

Hussein Halabi, Abdurhman S Al-Arfaj, Khaldoon Alawneh, Soliman Alballa, Khalid Alsaeid, Humeira Badsha, Romela Benitha, Elyès Bouajina, Samar Al Emadi, Ayman El Garf, Khaled El Hadidi, A. Laatar, C. Dahou-Makhloufi, Abdel Fattah Masri, Jeanine Menassa, Ahmed Al Shaikh, Ramiz Al Swailem, Maxime Dougados,

Systemic Lupus Erythematosus Research

Abstract Early diagnosis and early initiation of disease‐modifying antirheumatic drug ( DMARD ) therapy slow the progression of joint damage and decrease the morbidity and mortality associated with rheumatoid arthritis ( RA ). According to the E uropean L eague A gainst R heumatism ( EULAR ) guidelines, treatment should be initiated with methotrexate and addition of biological DMARD s such as tumour necrosis factor ( TNF ) inhibitors should be considered for RA patients who respond insufficiently to methotrexate and/or other synthetic DMARD s and have poor prognostic factors. Africa and the M iddle E ast is a large geographical region with varying treatment practices and standards of care in RA . Existing data show that patients with RA in the region are often diagnosed late, present with active disease and often do not receive DMARD s early in the course of the disease. In this review, we discuss the value of early diagnosis and remission‐targeted treatment for limiting joint damage and improving disease outcomes in RA , and the challenges in adopting these strategies in Africa and the Middle East. In addition, we propose an action plan to improve the overall long‐term outlook for RA patients in the region.