Why remission is not enough: underlying disease mechanisms in RA that prevent cure

Schett G, Tanaka Y, Isaacs JD (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Nature Reviews Rheumatology Nature Publishing Group

DOI: 10.1038/s41584-020-00543-5

Abstract

Cure is the aspirational aim for the treatment of all diseases, including chronic inflammatory conditions such as rheumatoid arthritis (RA); however, it has only been during the twenty-first century that remission, let alone cure, has been a regularly achievable target in RA. Little research has been carried out on how to cure RA, and the term ‘cure’ still requires definition for this disease. Even now, achieving a cure seems to be a rare occurrence among individuals with RA. Therefore, this Review is aimed at addressing the obstacles to the achievement of cure in RA. The differences between remission and cure in RA are first defined, followed by a discussion of the underlying factors (referred to as drivers) that prevent the achievement of cure in RA by triggering sustained immune activation and effector cytokine production. Such drivers include adaptive immune system activation, mesenchymal tissue priming and so-called ‘remote’ (non-immune and non-articular) factors. Strategies to target these drivers are also presented, with an emphasis on the development of strategies that could complement currently used cytokine inhibition and thereby improve the likelihood of curing RA.

Authors with CRIS profile

Georg Schett Lehrstuhl für Innere Medizin III

Involved external institutions

University of Occupational and Environmental Health Japan / 産業医科大学 JP Japan (JP) Newcastle University GB United Kingdom (GB)

How to cite

APA:

Schett, G., Tanaka, Y., & Isaacs, J.D. (2020). Why remission is not enough: underlying disease mechanisms in RA that prevent cure. Nature Reviews Rheumatology. https://doi.org/10.1038/s41584-020-00543-5

MLA:

Schett, Georg, Yoshiya Tanaka, and John D. Isaacs. "Why remission is not enough: underlying disease mechanisms in RA that prevent cure." Nature Reviews Rheumatology (2020).

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