Rheumatoid arthritis — master index¶
Last curated: 2026-08-31 · status: audited through 2026-08-31 · 18 curated wiki pages · 262-paper live-retrieved master bibliography · 6 landmark-paper notes · 27-document guideline registry · 94-row statistics sheet · 9 verified patient-organization resources · 34 open questions + 18 unconnected-dots junctions
The condition in five sentences. Rheumatoid arthritis is a heterogeneous systemic autoimmune disease centered on persistent synovitis, with joint destruction and lung, vascular, bone, eye, nerve and infection consequences. GBD 2021 estimated 17.6 million people living with RA in 2020 and projects 31.7 million in 2050, while model and case-definition uncertainty remain substantial (GBD 2021 RA Collaborators 2023, PMID 37795020). ACPA/RF autoimmunity can predate swelling by years, and genetic susceptibility, smoking and mucosal biology shape risk without determining individual destiny (Dedmon 2020, PMID 32638005; Greenblatt 2020, PMID 32205569). Early methotrexate-centered treat-to-target care, followed when necessary by biologic or targeted therapy, prevents damage for many, but residual symptoms, difficult-to-treat disease, infection and JAK cardiovascular/cancer safety require mechanism- and risk-specific decisions (Grigor 2004, PMID 15262104; Ytterberg 2022, PMID 35081280). Prevention with abatacept, synovial-biopsy-guided selection and RA-ILD trials define the frontier, but none yet supplies a universal preventive, precision or lung-treatment algorithm (Rech 2024, PMID 38364841; Humby 2021, PMID 33485455; Saavedra 2025, PMID 39822854).
Start here: overview. Frontier: OPEN-QUESTIONS.md. Growth history: LOG.md.
Reading paths¶
- Clinical path — overview → classification and diagnosis → treat to target and remission → conventional DMARDs → biologic DMARDs → JAK inhibitors → guidelines
- Origins and mechanism path — preclinical autoimmunity → genetics, environment and mucosa → synovial immunobiology → biomarkers and tissue precision
- Safety and systemic path — extra-articular disease → RA-ILD → red flags
- Frontier path — open questions → clinical trials → biomarkers and tissue precision → difficult-to-treat RA
- Human and population path — epidemiology and burden → patient experience and advocacy → statistics → patient-voice themes
Pages¶
| Section | Page | Scope | Status |
|---|---|---|---|
| Foundations | overview.md | Autoimmunity, burden, treat-to-target care and frontier | curated |
| Foundations | classification-and-diagnosis.md | 2010 criteria, differential, serostatus and early arthritis | curated |
| Foundations | epidemiology-and-burden.md | Prevalence, incidence, disability, mortality and inequalities | curated |
| Origins | preclinical-autoimmunity-and-prevention.md | ACPA/RF phases, at-risk states and prevention trials | curated |
| Origins | genetics-environment-and-mucosal-origins.md | HLA, smoking, periodontium, lung and microbiome | curated |
| Mechanism | synovial-immunobiology.md | T/B cells, macrophages, fibroblasts, cytokines and erosion | curated |
| Clinical | treat-to-target-and-remission.md | Composite scores, remission, monitoring and tapering | curated |
| Clinical | conventional-dmards.md | Methotrexate, leflunomide, sulfasalazine and hydroxychloroquine | curated |
| Clinical | biologic-dmards.md | TNF, IL-6, B-cell and T-cell-costimulation therapies | curated |
| Clinical | jak-inhibitors-and-targeted-therapy.md | Efficacy, positioning, MACE/cancer/VTE signals | curated |
| Clinical | difficult-to-treat-and-refractory-ra.md | Definition, inflammation, pain, adherence and sequencing | curated |
| Systemic | extra-articular-and-comorbid-disease.md | Cardiovascular, infection, bone, eye, nerve and vasculitis | curated |
| Systemic | ra-associated-interstitial-lung-disease.md | Screening, phenotypes, prognosis and treatment | curated |
| Clinical | guidelines.md | EULAR, ACR and regional strategy differences | curated |
| Frontier | biomarkers-and-tissue-precision.md | Autoantibodies, omics, synovial biopsy and imaging | curated |
| Frontier | clinical-trials-landscape.md | Prevention, safety, biopsy and RA-ILD registrations | curated |
| Human | patient-experience-and-advocacy.md | Pain, fatigue, work, treatment burden and organizations | curated |
| Safety | red-flags-and-safety-concerns.md | Septic joint, cervical instability, lung decline and immunosuppression | curated |
Literature layer¶
| Artifact | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 262 live-retrieved PubMed records with page provenance | audited through 2026-08-31 |
| notes/ | Six deep notes: criteria, TICORA, ATTRACT, ORAL Surveillance, R4RA and ARIAA | audited |
| guidelines/REGISTRY.md | 27 current/historical documents, supersession chains, disagreements and watch list | audited through 2026-08-31 |
| statistics/STATISTICS.md | 94 method- and population-labelled quick-reference rows | audited through 2026-08-31 |
| patient-voice/README.md | Method and ethics | audited |
| patient-voice/organizations.md | Nine verified public organization resources | audited |
| patient-voice/themes.md | Eight cross-source themes | audited |
| patient-voice/sources.md | Annotated sources and coverage limits | audited |
Curation state¶
This condition was audited on 2026-08-30 in the separate pass required by BUILD-PLAYBOOK.md. An independent audit of the 2026-08-31 literature sweep (auditor: Grok; author: Codex) re-fetched every newly added PMID and NCT and confirmed the two edited wiki pages. The condition tree holds 262 unique PMIDs and 31 NCT identifiers. Registry UNKNOWN trial statuses are retained only where ClinicalTrials.gov currently returns that label.