Inn Med (Heidelb). 2026 Jun 2. doi: 10.1007/s00108-026-02138-w. Online ahead of print.
ABSTRACT
BACKGROUND: Rheumatoid arthritis (RA) is a common chronic inflammatory disease and a systemic autoimmune disorder associated with increased morbidity and mortality due to multiorgan involvement.
OBJECTIVES: To summarize pathophysiology, clinical presentation, diagnostics and modern treatment strategies of RA, and to highlight its relevance for internal medicine.
METHODS: Narrative review of current literature, guidelines and clinical studies with a focus on clinically relevant aspects regarding diagnosis, treatment, and comorbidities.
RESULTS: RA results from a complex interaction of genetic predisposition and immune dysregulation leading to autoantibody formation and chronic inflammation. Clinically, it typically presents as symmetric polyarthritis, although early and atypical manifestations are common. Diagnosis is primarily clinical and is supported by serology and imaging. Early treatment following a treat-to-target strategy with disease-modifying anti-rheumatic drugs (DMARDs) enables remission in many patients. Comorbidities, particularly cardiovascular disease, significantly contribute to disease burden.
CONCLUSION: RA requires early recognition, timely initiation of therapy, and interdisciplinary management. Internists play a key role in early diagnosis, risk stratification and long-term care.
PMID:42230348 | DOI:10.1007/s00108-026-02138-w