Inflammatory debate: The brave new world of rheumatoid arthritis management

IT IS A chronic, autoimmune disease where inflammation of synovial tissue in peripheral joints leads to progressive and irreversible joint destruction, loss of mobility and pain. Primary targets are metatarsophalangeal and metacarpophalangeal joints, with later involvement of medium size joints -- e.g. ankles and wrists and larger joints such as knees. Joint pain and stiffness is worse on waking and can be relieved by activity. Typical systemic symptoms include malaise, fever, weight loss and anorexia.