It is well established that the persistence of joint inflammation is the main cause of progressive structural damage and disability throughout the disease, and that the control of inflammatory activity reduces the progression of structural damage.
In a recent meta-analysis, four independent predictors of poor response to disease-modifying treatments were identified: female sex, marked disability (class III of the ARA Keto Viante), previous use of modifying therapy and, above all, the duration of arthritis.
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