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Clinical Crossroads
September 27, 2000

A 55-Year-Old Woman With Rheumatoid Arthritis, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2000;284(12):1567. doi:10.1001/jama.284.12.1567

In April 1999, Steven R. Goldring, MD, discussed a 55-year-old woman with rheumatoid arthritis.1 The patient, Mrs J, who also has type 1 diabetes mellitus, retired from her profession as a restaurateur because of her painful and disabling joint symptoms. She had tried multiple medications unsuccessfully and was being treated with leflunomide and prednisone, 10 mg in the morning and 5 mg at night. Mrs J described difficulty opening jars and doors, but characterized herself as "a fighter." Dr Goldring gave an overview of rheumatoid arthritis and shared his insights regarding pathology, pathogenesis, and disease assessment and treatment strategies. He suggested that Mrs J might benefit from the addition of a second or even a third disease-modifying antirheumatic drug or perhaps a trial of etanercept. We asked the patient and her physician to comment on the year that has passed.

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