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In the last 25 years we have witnessed a change in the approach to rheumatoid arthritis. These changes have made it possible to modify the clinical course and prognosis of the disease, with the subsequent improvement in the quality of life of our patients. This Special Issue explores the most important changes that have occurred in recent years. It starts with an excellent point of view on preclinical arthritis and how we must treat it, considering the window of therapeutic opportunity. Next, because the RA is a condition that predominantly affects women, we discuss the disease through the lens of gender, empathizing the need for this perspective to achieve better research results and personalized medicine. Regarding treatment, the issue takes a journey that begins with the necessity of changing the old paradigm of treatment and the necessity of advancing DMARD lines. We then continue with the anchor drug, methotrexate, and its toxicity then advancing with the real-world persistence of Janus kinase inhibitors, sex differences in response to JAKi and infections related to these drugs. Finally, we examine comorbidities, starting with the Interstitial lung disease, Neutropenia and Felty syndrome and the relevance of radiographic progression. I hope that the issue can be useful for clinicians, rheumatologists, internal medicine specialists, primary care physicians, hematologists, pneumologists, etc. involved in the care of rheumatoid arthritis patients.
