Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease that requires early treatment to prevent articular damage. Treatment with first line conventional DMARDs may be accompanied by side effects. Approximately 20 percent of patients with RA fail to respond to conventional DMARDs within 5 years and require biological DMARDs. However, a significant portion of the patients on tumor necrosis factor inhibitors, lose response over time or are unable to tolerate treatment. Furthermore, treatment with biological DMARDs may result in serious infectious complications. We will discuss a case of a 76 year old man with seropositive RA whose arthritis treatment was hampered by multiple problems during the course of his disease.