RHEUMATOID ARTHRITIS - CURRENT PERSPECTIVES ON EPIDEMIOLOGY, DIAGNOSIS AND TREATMENT

Karol Józef Szkarłat; Maksymilian Szklarski; Michał Stachel; Jędrzej Sztajura; Szymon Targosz; Ewa Maraszewska; Weronika Szymacha; Aleksandra  Płecka; Karol Zimnicki; Alicja Stępień

doi:10.31435/ijitss.2(50).2026.5456

Authors

Karol Józef Szkarłat Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0004-2889-8382
Maksymilian Szklarski Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0001-6977-0666
Michał Stachel Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0008-3264-4747
Jędrzej Sztajura Students’ Scientific Club, Department of Neurosurgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0009-8975-731X
Szymon Targosz Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0005-2251-5229
Ewa Maraszewska Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0003-0992-7144
Weronika Szymacha Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0000-1592-5602
Aleksandra Płecka Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0007-0075-5234
Karol Zimnicki Medical University of Silesia in Katowice, Faculty of Medical Sciences in Katowice, Katowice, Poland https://orcid.org/0009-0001-9687-2641
Alicja Stępień Voivodship Dental Clinic, Consulting Dental Prosthetics Department, Cracow, Poland https://orcid.org/0009-0003-2717-6030

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5456

Keywords:

Rheumatoid Arthritis, Rheumatoid Factor, Anti-Citrullinated Protein Antibodies, Synovitis

Abstract

Introduction and purpose: Rheumatoid arthritis (RA) is a complex immune-mediated inflammatory disease characterized by a loss of self-tolerance and chronic systemic involvement. Its pathogenesis is driven by a sophisticated interplay between genetic predispositions and environmental triggers including gut microbiota dysbiosis. Modern diagnostic frameworks have shifted toward precision medicine, utilizing advanced biomarkers. Beyond progressive joint destruction, the clinical burden of RA encompasses debilitating pain driven by neuroimmune sensitization and a high prevalence of systemic comorbidities. Effective management now relies on a holistic "treat-to-target" strategy that integrates targeted therapies, such as JAK inhibitors and biologics, with structured physical activity to restore functional independence and improve quality of life. This review summarizes the current knowledge, focusing on pathophysiology, epidemiology, diagnosis and treatment. By integrating current knowledge and new findings, it aims to enhance and optimize patient care.

Description of the State of Knowledge: Rheumatoid arthritis (RA) is currently understood as a complex immune-mediated inflammatory disease driven by a breakdown in self-tolerance, where genetic markers like HLA-DRB1 and FCRL3 interact with environmental triggers such as gut microbiota dysbiosis. Detection of classic autoantibodies - Rheumatoid Factor (RF) and Anti-Citrullinated Protein Antibodies (ACPA) - remains a cornerstone of clinical evaluation. Modern diagnostics have shifted toward precision medicine, utilizing synovial pathotyping and novel biomarkers like 14-3-3η to identify specific inflammatory subtypes for targeted intervention. The clinical burden extends beyond joint destruction to include neuroimmune-driven pain and systemic comorbidities, necessitating a holistic "treat-to-target" approach. Therapeutic strategies now integrate advanced JAK inhibitors and biologics with non-pharmacological pillars like physical activity to achieve remission and restore functional independence.

Conclusions: Modern RA management defines the disease as a systemic autoimmune condition triggered by genetic factors and environmental stressors like smoking or gut dysbiosis. Diagnostics have shifted toward a "treat-to-target" approach using precise indices like DAS28. Treatment has been revolutionized by JAK inhibitors, yet effective care must remain holistic. Notably, CAR T-cell therapy is becoming increasingly promising in clinical research as a potential way to "reset" the immune system. Beyond suppressing inflammation, a modern strategy must address neuroimmune-driven pain and fatigue through structured physical activity to truly restore a patient's quality of life.

Materials and methods: A review of recent clinical studies and scientific articles was conducted, focusing primarily on pathophysiology, epidemiology, clinical presentation, diagnosis and treatment, supplemented with the latest findings.

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