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Genetic Determination of Susceptibility and Severity in Rheumatoid Arthritis

Robert Winchester, MD
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Requests for Reprints: Robert Winchester, MD, Division of Autoimmune and Molecular Diseases, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032.

College of Physicians and Surgeons of Columbia University
New York, NY 10032

Ann Intern Med. 1992;117(10):869-871. doi:10.7326/0003-4819-117-10-869
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Rheumatoid arthritis is increasingly recognized to be a potentially severe illness that shortens life expectancy by an average of 10 to 15 years. Indeed, patients with severe articular and extra-articular disease have 5-year survival rates of less than 50%, similar to survival in patients with stage IV Hodgkin disease (1, 2). Moreover, the long-term outlook for roughly half of all patients receiving the best current treatment for rheumatoid arthritis is not an optimistic one (3). Although current practice involves treating more seriously involved patients with considerably more aggressive antiinflammatory and immunosuppressive drugs than are used in those with milder disease,


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