The treatment of rheumatoid arthritis emphasizes early treatment. The current internationally recognized window for the treatment of rheumatoid arthritis is 3 months, i.e., patients can develop synovial or cartilage destruction within 3 months of the onset of the disease, at which point they should begin treatment with antirheumatic drugs that provide relief. A recent study by Italian scholars also demonstrated that in clinical practice, very early rheumatoid arthritis is the best time to achieve complete remission and stop the progression of aggressive lesions. A total of 121 patients with early rheumatoid arthritis (ERA) were included in the study. After 3 months of treatment with methotrexate (MTX), if patients did not achieve a disease activity score of 44 joints (DAS 44) ≤ 2.4, they were followed by combination anti-tumor necrosis factor therapy. All subjects received hand and foot joint x-rays at the start of the trial and 12 months later. Very early rheumatoid arthritis was defined as the onset of disease symptoms shorter than 12 weeks. Results showed that 46.3% of patients achieved remission of disease activity and 24.8% achieved American College of Rheumatology remission. 12 months later, very early rheumatoid arthritis was the only predictor of not developing new aggressive lesions.