This could lead to a paradigm shift in the treatment of rheumatoid arthritis: rheumatologists at the Medical University of Vienna have discovered, through a secondary study involving 3,000 female patients, that the condition of the cartilage in inflammatory joint rheumatism needs to be paid more attention than has previously been the case. Until now, the focus lay mainly on investigating the damage to the bone. The study also revealed that the signs of joint swelling are given more attention than the results of blood tests.
"It is important to maintain the joint's function. This is our aim, so that the patient retains the ability to pour a glass of milk, get out of the car or be able to wash him or herself. Our study has shown that preserving the cartilage structure for this level of functioning is more important than preserving bone structure. Bone structure can essentially be re-built, however damage to cartilage is irreparable. Cartilage is therefore the much greater problem in rheumatoid arthritis", says Josef Smolen, Director of the Clinical Division of Rheumatology of the University Department of Internal Medicine III. Smolen was only crowned by "Laborjournal online" as the most-cited German-speaking rheumatologist in middle of July 2011. In the field of rheumatology, Europe leaves the USA, which is usually the leader in all things medical, behind - and in Europe, Vienna is regarded as "the" leading centre for rheumatology.
Earlier treatment of cartilage
The results of the study show that in future more attention needs to be paid to the cartilage during diagnosis, for example during X-rays, while on the other hand treatment needs to be commenced earlier, and this includes preventative therapy. There are currently around 15 highly potent, anti-inflammatory medications available for this. Daniel Aletaha, the primary author of the study: "We need to protect both the cartilage and the bone from destruction. With X-rays, for example, slightly less attention has been paid in the past to cartilage destruction. This needs to be re-examined across the world in the light of our study results."