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Timing the therapeutic window of opportunity in early rheumatoid arthritis: proposal for definitions of disease duration in clinical trials
  1. Karim Raza1,
  2. Tajvur P Saber1,
  3. Tore K Kvien2,
  4. Paul P Tak3,
  5. Danielle M Gerlag3
  1. 1Division of Immunity and Infection, Rheumatology Research Group, University of Birmingham, Birmingham, UK
  2. 2Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  3. 3Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Karim Raza, Division of Immunity and Infection, Rheumatology Research Group, University of Birmingham, Birmingham B15 2TT, UK; k.raza{at}


The effects of treatment in early rheumatoid arthritis (RA) and the consequences of delayed therapy represent important areas for research. The concept of a ‘window of opportunity’ is now well established and considerable attention has been paid to when it might close. However, in order to study how long the window of opportunity lasts, the timing of its opening must be precisely defined. An analysis of definitions of ‘onset’ in clinical studies reveals imprecision and heterogeneity, making accurate assessment of this important concept of the ‘window of opportunity’ very difficult. In this paper we propose that, in clinical trials in early RA, data on durations since onset of symptoms and onset of joint swelling as well as disease duration based on fulfilment of classification criteria should be routinely presented.

  • Rheumatoid Arthritis
  • Treatment
  • Early Rheumatoid Arthritis

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