Vivian Bykerk, MD: Treating RA Early

Vivian Bykerk, MD, associate attending rheumatologist at the Hospital for Special Surgery, associate professor of medicine at Weill Cornell Medical College, explains why treating rheumatoid arthritis (RA) early is crucial.


Why is it important for patients with RA to get treatment early in the course of their disease?

You can imagine, if you allow each joint to be infiltrated with a large number of immune cells that are creating messengers, we call them cytokines, and other messengers that seek to destroy, basically cause damage, that you don’t ever want those joints to get to that stage.

In other words, we want to meet people when they’re first developing achiness and maybe the first swollen joint, so that we can literally control that and limit—modify the disease, in essence—the development of proliferative synovial tissue in the joint that causes damage.

Once that horse is out of the barn, it’s really hard to manage it. It’s possible, but it usually requires a whole level up, in terms of therapy.

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