New Perspectives on Treating Rheumatoid Arthritis

Patients with rheumatoid arthritis have symmetric synovitis of their peripheral joints and various degrees of joint destruction. In short-term studies, slow-acting antirheumatic drugs relieve symptoms and retard joint destruction, but many patients continue to have pain, stiffness, fatigue, and progressive disability.1 Better treatments are needed. This issue of the Journal includes reports of two randomized, controlled trials that investigated variations of widely used treatments for rheumatoid arthritis.2,3 In a six-month study of 148 patients with severe rheumatoid arthritis who had had only partial improvement with methotrexate, Tugwell et al. found greater clinical improvement with cyclosporine and methotrexate combined than . . .