Remodeling the pyramid--a concept whose time has come.

@article{Wilske1989RemodelingTP,
  title={Remodeling the pyramid--a concept whose time has come.},
  author={K R Wilske and Louis A Healey},
  journal={The Journal of rheumatology},
  year={1989},
  volume={16 5},
  pages={565-7}
}
It is clear that the traditional treatment program, as illustrated by the pyramid, does not suppress inflammation in most patients with RA to an extent sufficient to prevent joint damage. There is no basis for the concept that slow acting drugs are uniquely disease modifying. Disease modification correlates best with control of inflammation. Contrary to popular wisdom, this has been best demonstrated with prednisone. The arbitrary concept of a drug being either antiinflammatory or disease… CONTINUE READING

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