Page 65 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

HOW DOES ESTABLISHED RHEUMATOID ARTHRITIS DEVELOP
PRACTICE POINTS
• Worldwide RA incidence showed a steady decrease during the period 1955- 1995, followed by a recent increase in at least Denmark and the USA.
• New possible risk factors for the development of RA are non-alcohol use, coffee consumption, sugar-sweetened soda intake, obesity, physical inactivity, sleep disorders, and thyroid disease.
• Possible options for primary prevention of RA include dietary changes, weight reduction and dental care. No drug intervention has proven to be effective in the prevention of RA.
• With the advent of the 2010 ACR/EULAR criteria, the subgroup of UA in early ar- thritis patients is strongly reduced, and it contains mainly seronegative (oligo-) arthritis patients with a mild disease course.
• Secondary prevention of RA is becoming less of an issue due to the high sensi- tivity of the 2010 ACR/EULAR criteria in early disease, and the tendency to treat early arthritis rapidly.
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RESEARCH AGENDA
• Improve prediction models of RA by integrating personal characteristics, symp- toms and genetic information with new biomarkers.
• Establish simple prediction aids for different situations, for example, in the gen- eral practitioner (GP) office, the rheumatology clinic, or the general public.
• Controlled intervention studies in persons at risk of RA in different stages.
• Improved identification of UA with poor prognosis.
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