Rheumatoid arthritis (RA)
Rheumatoid arthritis (RA) has been postulated to develop in several phases; with inherited susceptibility factors in some cases leading to asymptomatic (or preclinical) citrullinated protein-directed autoimmunity, followed after some interval by the development of synovial infiltration and polyarticular disease. Yet, it is controversial whether progression to overt disease is uniformly unavoidable. In these presentations, different perspectives on preclinical autoimmunity will be presented. Rationales will also be discussed for the selection of agents with different mechanisms of action (MOA), proven for the treatment of active RA, and for arresting or even reversing pathogenesis at the preclinical stage. Faculty will then review interim progress in evaluations of rituximab, hydroxychloroquine and abatacept in individuals with preclinical autoimmunity, as well as also consider the merits other, potential interventions suggested by ongoing studies of the pathogenesis of preclinical RA. Our program will conclude with an interactive panel discussion.