Epilogue: How Will We Care for Patients with Early Arthritis? Richard S. Panush, MD a, *, Francisco P. Quismorio Jr, MD, MACR a , David A. Fox, MD b Knowing is not enough; we must apply. Willing is not enough; we must do. —Goethe 1 Caring optimally for patients with early arthritis is one of the exciting challenges of contemporary rheumatology. Indeed we perceive this to be an urgent societal imperative. 2 The superb contributions to this timely issue of Rheumatic Disease Clinics frame many of the pertinent issues. These articles inform us and permit us to identify the key questions, and provide an elegant state-of-the-art summary of potential predic- tors/triggers of inflammatory arthritis, sophisticated imaging (and serologic) methods to establish early/preclinical disease, and principles to guide the therapy for these patients to maximize their opportunity for favorable outcomes. Several important questions remain unanswered. When does disease begin? This is a critical issue. The autoimmune diathesis that generates disease, when specific enough, is arguably a point of disease onset, and could be more amenable to treatment, even cure, perhaps with different approaches than we use in established disease. Considering that statins are increasingly used in primary and not just secondary pre- vention of vascular disease, we need not be too timid about considering treatment at this stage. When should therapeutic intervention occur? What are needed are biomarkers that can guide treatment for both disease subsets and disease severity. In the not too distant future individual genetic profiles, even complete genomic sequences, may contribute not only to risk assessment but also to early diagnosis. It seems likely a Division of Rheumatology, Department of Medicine, Keck School of Medicine at the Univer- sity of Southern California, USC Medical Center, IRD 427, 2010 Zonal Avenue, Los Angeles, CA 90033, USA; b Division of Rheumatology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109-5358, USA * Corresponding author. E-mail address: panush@usc.edu KEYWORDS  Early arthritis  Care  Rheumatoid arthritis  Prevention Rheum Dis Clin N Am 38 (2012) 427–429 doi:10.1016/j.rdc.2012.04.003 rheumatic.theclinics.com 0889-857X/12/$ – see front matter Ó 2012 Elsevier Inc. All rights reserved.