TY - JOUR T1 - A Rheumatologist Managing Patients with Rheumatoid Arthritis: An Artisan But Also An Artist! JF - The Journal of Rheumatology JO - J Rheumatol SP - 2064 LP - 2065 DO - 10.3899/jrheum.121086 VL - 39 IS - 11 AU - MAXIME DOUGADOS Y1 - 2012/11/01 UR - http://www.jrheum.org/content/39/11/2064.abstract N2 - In this issue of The Journal Lonnie Pyne and colleagues report the results of an analysis aimed at evaluating the respective roles of the patient (patient’s global assessment), the physician (physician’s global assessment), and a composite index, the Disease Activity Score (DAS)1 in the decision for indicating and/or reinforcing a disease-modifying drug in rheumatoid arthritis (RA) in daily practice in Canada2. For this purpose, they took the opportunity to use data collected in the CATCH study (the Canadian Early Arthritis Cohort). The main conclusion of this elegantly conducted analysis is that the increase of treatment was strongly related to the physician’s global assessment, whereas DAS28 was not.The results have to be interpreted with regard to the following new paradigms in the management of RA, in particular at the early stage of the disease. The current main objective of therapy with a disease-modifying antirheumatic drug (DMARD) in early RA is not only to improve the current symptomatic condition of the patient (e.g., level of pain, functional impairment, fatigue) but also to prevent any subsequent clinical handicap due to structural damage. Inflammation has been shown in different longitudinal epidemiological … Address correspondence to Prof. Dougados; E-mail: m.doug{at}cch.aphp.fr ER -