Looking back at the evolution of RA therapeutics, it is easy to suggest that serendipity played a major role in drug development. No doubt most great discoveries require some proper alignment of the stars, but I would argue that many of the breakthroughs occurred because of the careful diligence of the investigators. They often followed false leads, but kept their minds open to all the possibilities.
What happened to Michael? Unfortunately, the therapeutic revolution arrived too late to prevent the damage that required so many surgeries to repair. However, the biologics allowed him to completely wean off his dreaded prednisone. Michael’s current rheumatologist tells me that he is grateful for these small victories.
Taking care of Michael had a profound effect on my career choice. Thirty years ago, we could not effectively treat rheumatoid arthritis. I think that luck or fate determined patient outcomes more than our treatments. But all that has changed. We have not yet achieved a cure for rheumatoid arthritis, but we are getting so much closer to that target.
Dr. Helfgott is physician editor of The Rheumatologist and associate professor of medicine in the division of rheumatology, immunology, and allergy at Harvard Medical School in Boston.
