Retinoid Therapy for Rheumatoid Arthritis

Excerpt

Effective therapeutic intervention in the course of rheumatoid arthritis often involves using more than one class of drugs. This use of polypharmacologic therapy is not surprising considering the complex pathophysiologic process of the disease. In rheumatoid arthritis, acute inflammation, manifested by large numbers of polymorphonuclear leukocytes in the synovial fluid and activation of the clotting, kinin, and fibrinolytic systems, is matched both by chronic inflammation involving macrophages and lymphocytes in the synovium and by enormous proliferation of synovial cells capable of generating enzymes that destroy cartilage, tendon, and bone. Indeed, because of the aggressive manner in which it destroys joints,