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Rheumatoid arthritis in the critically ill 

Rheumatoid arthritis in the critically ill
Chapter:
Rheumatoid arthritis in the critically ill
Author(s):

Rodrigo Cartin-Ceba

and Udaya B. S. Prakash

DOI:
10.1093/med/9780199600830.003.0278
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date: 18 October 2021

Rheumatoid arthritis is a progressive chronic inflammatory disease of autoimmune aetiology, characterized by joint swelling, tenderness, and destruction of synovial joints, leading to severe disability and premature mortality. The prevalence of rheumatoid arthritis has been estimated at 0.5–1% of the adult population and is the most common form of inflammatory joint disease. Rheumatoid arthritis frequently affects many non-articular systems, most commonly the cardiopulmonary, gastrointestinal, and haematological systems. Over recent years, the optimal use of disease-modifying anti-rheumatic drugs, in particular methotrexate, and the availability of several new biological agents, have dramatically enhanced the success of rheumatoid arthritis management. Multiple studies have demonstrated the efficacy of anti-TNF therapy, as well as other targeting, in reducing inflammatory activity, as well as inhibiting joint destruction in patients with active rheumatoid arthritis. A significant number of patients admitted to the intensive care unit (ICU) with autoimmune conditions have rheumatoid arthritis. The studies evaluating the outcome of rheumatoid arthritis patients admitted to the ICU have included other rheumatological conditions, but all have identified a high mortality (17–55%).

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