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  1. Majithia V, Geraci, SA. Rheumatoid Arthritis: Diagnosis and Management. American Journal of Medicine 2007; 120: 936-939.
  2. Choy, EHS, Panayi, G. Cytokine Pathways and Joint Inflammation in Rheumatoid Arthritis. New England Journal of Medicine. 344 (12); March 22, 2001: 907-916.
  3. Bang H et al, Mutation and Citrullination Modifies Vimentin to a Novel Autoantigen for Rheumatoid Arthritis. Arthritis Rheum. 56 (8); Aug 2007: 2503-2511.
  4. Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis Rheum. 2008; 58(1):15-25.
  5. Saag KG,et al. ACR 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008; 59(6):762-84

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Rheumatoid Arthritis is a common and painful disease that requires prompt and accurate treatment.


Rheumatoid arthritis (RA) is a common illness that is characterized by prolonged periods of stiffness and pain in the joints. Women are affected nearly 3 times more than men, and symptoms typically appear between age 30-50 [1]. Joint pain in RA is caused by irritation and swelling of the tissue that lines the joints. Over time, the problem can harm cartilage, bone, and surrounding tissue [2]. Early diagnosis and appropriate treatment can limit the impact of RA [3]. Early and accurate diagnosis is made more difficult by the large number of conditions that can cause similar symptoms.

RA is an autoimmune disease for which there is presently no cure. Therefore RA treatments focus on minimizing symptoms in order to slow disease progression and maintain quality of life. It is estimated that 1.3 million Americans suffer from RA [4].

There are a variety of treatment options for RA. Depending on the severity and duration of symptoms, current guidelines suggest the use of one or more disease-modifying antirheumatic drugs (DMARDs). Methotrexate, alone or in combination with other DMARDs, is a very commonly used medication for the treatment of RA. In rapidly progressing cases, or when an insufficient response is seen using traditional DMARDS, then a patient may be prescribed biologic response modifiers ("biologics"). Biologics are recognized for their rapid and effective reduction of RA symptoms when response to DMARDs is insufficient. Treatment cost issues and insurance restrictions may impact decisions on the use of biologics [5].

Using personalized medicine such as the Avise testing services can help accurately diagnose RA as well as help to optimize the dosing of a common front-line DMARD, methotrexate, giving patients their best chance for optimal therapy.