rheumatoide

Rheumatoide is an adjective used in several Romance languages to indicate relation to rheumatism or rheumatic diseases. In medical contexts, it most often refers to rheumatoid arthritis (artritis reumatoide), a chronic autoimmune inflammatory disease that primarily targets the joints but can involve other organs.

Rheumatoid arthritis is characterized by synovial inflammation, proliferation of the lining (pannus), and progressive destruction of cartilage and bone, leading to pain, swelling, stiffness, and eventual deformity. The disease typically presents with symmetric joint involvement and morning stiffness lasting more than 30 minutes. Extra-articular manifestations may include lung, heart, skin, and ocular conditions, and systemic symptoms such as fatigue.

Pathophysiology involves genetic susceptibility (notably HLA-DRB1 alleles) and environmental triggers such as smoking, leading to an autoantibody response. Common autoantibodies include rheumatoid factor (RF) and anti-citrullinated peptide antibodies (anti-CCP). Pro-inflammatory cytokines like TNF, IL-1, and IL-6 drive synovitis and tissue damage.

Diagnosis relies on clinical features, serology, inflammatory markers, and imaging. The 2010 ACR/EULAR criteria are commonly used to classify early rheumatoid arthritis. Early, aggressive treatment improves outcomes.

Management aims to reduce inflammation, control symptoms, and prevent joint damage. First-line therapy typically uses disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, often combined with bridging glucocorticoids. If response is inadequate, biologic or targeted synthetic DMARDs (e.g., TNF inhibitors, IL-6 inhibitors, JAK inhibitors) are added. Non-pharmacologic measures (exercise, physical/occupational therapy, smoking cessation) and vaccinations are part of comprehensive care.

Prognosis has improved with timely therapy; many patients reach remission or low disease activity, though cardiovascular risk remains higher than in the general population.