Rose,
Part of the problem is that the anti-TNF therapy is relatively new and quite expensive. There is little evidence yet to support early intervention. Nonetheless, some is appearing, e.g.,
Enbrel especially helpful for early arthritis.
An ally in the battles with the third party payors and the pharmaceutical companies that make the drugs. They can help your rheumatologist with information that supports use of their drugs.
Best regards,
jcwinnie
