최근 류마티스 관절염 치료는 새로운 항류마티스 약제와 생물학적 제제의 도입 등 여러 혁신적 변화를 통해, 과거에 비해 괄목할만한 치료 효과를 보이고 있다. 치료의 개념도 과거의 피라미드식 접근 방법에서 조기 진단과 더불어 강력한 치료를 질병 초기에 시행함으로써 질병의 진행을 억제하는 것으로 바뀌었다. 류마티스 관절염을 조기에 진단하여 질병의 초기부터 강력한 치료를 하는 것이 환자의 예후에 있어 매우 중요하다.

The paradigm for the management of rheumatoid arthritis (RA) has shifted in the past two decades. The appreciation of increased mortality in patients with RA and the poor outcomes with conventional therapy led to the concept of the early aggressive treatment to suppress ongoing inflammation and prevent joint injury. RA results from acute and chronic inflammation in the synovium associated with proliferative and destructive processes in the joint. Affected areas may either heal without structural defects, or be irreversibly damaged if inflammation is severe and does not remit. Therefore, measures aimed at identifying early active disease and ameliorating inflammation are essential and may be highly effective in modifying disease outcome. The goal of treatment is to achieve and maintain a state of remission or, at the least, a state of low disease activity, in order to prevent joint damage and disability. This requires the initiation of treatment early in the disease process, as well as vigilant monitoring throughout the course of disease, with prompt readjustment of therapy, for flares of activity and for medication toxicity. This aggressive approach has been made possible by the increasing number of effective non-biologic and biologic disease-modifying anti-rheumatic drugs (DMARDs). Recent trends and guidelines for the management of RA are presented here. (Korean J Med 76:18-24, 2009)