Treatment of early undifferentiated arthritis

Undifferentiated arthritis progresses to RA in one third of cases and spontaneously remits in up to half of patients, with disease persistence and the development of RA more likely in those with the greater clinical burden of synovitis. Clinical and laboratory characteristics can be utilized within algorithms to more accurately predict disease progression and a need for disease modifying therapy. Biological agents are not required as first line therapy with excellent results from traditional DMARDs if a treat to target approach is used and early intense escalation of therapy undertaken when outcome targets are not achieved.