Rheumatoid arthritis (RA) is a progressive disease which causes chronic inflammation of the joints. It generally affects the smaller joints in the body such as fingers, thumbs, wrists, feet and ankles.
However, the systemic nature of the condition means that it can also affect the body as a whole. RA is one of a group of conditions classified as autoimmune diseases, where the immune system attacks the body’s own tissues, specifically the synovium, the tissue that surrounds joints.
How many people suffer from rheumatoid arthritis?
It is estimated that over 5 million people suffer from RA in UCB’s top 7 markets (France, Germany, Italy, Japan, Spain, U.K., U.S.). Prevalence is not split evenly between genders, since women are three times more likely to be affected than men.
Although RA can occur at any age, the disease most commonly begins between the ages of 40 and 60.
Women are three times more likely to be affected than men.
What causes rheumatoid arthritis?
Doctors are still unable to pinpoint the exact cause of RA. It is thought that genetic, environmental and hormonal factors all play a role.
RA is not necessarily passed from generation to generation. Many scientists believe that there are environmental factors that can trigger the development of RA in susceptible individuals. These triggers, which lead to the immune system attacking the healthy synovium, are thought to be bacterial and/or viral. In addition, cigarette smoking also significantly increases the risk of developing RA.
Symptoms of RA may come and go and vary in severity from patient to patient. The main symptoms are:
- Joint stiffness
- Joint pain
- Redness and warmth around the area affected
- Reduction in mobility
- Appearance of nodules or lumps under the skin
- Deformity of joints
- General fatigue
Patients often experience symmetrical symptoms, whereby any symptoms felt on one side of the body are reflected in the same joints on the other side.
These symptoms can lead to permanent damage of joints and bones. As this damage occurs, patients may find their movement becomes more restricted, and this can lead to difficulty in undertaking even the simplest everyday tasks such as combing hair, turning a doorknob or taking a walk.
In more severe cases RA can lead to disability, and given the age of the average RA patient, the cost of work-related disability is usually a larger societal burden than the cost of RA treatment.
RA patients are also at a higher risk of developing other conditions, in particular heart disease, stroke, infections, lung problems and osteoporosis. There is no clear reason why this should be the case, however, lack of exercise and mobility are risk factors for developing many of these conditions.
How is rheumatoid arthritis diagnosed?
Diagnosis of RA is not always easy, since initial symptoms may be subtle and occur gradually, and early stage RA shares a number of symptoms with other musculoskeletal diseases
There is also no one clear way to diagnose RA, so the physician has to rely on a combination of medical history, physical examinations and laboratory tests. The two kinds of laboratory tests used to aid diagnosis are blood tests and x-rays or imaging techniques.
Early diagnosis is important as joint damage begins to occur in the first two years of the disease or less.
What is the goal of treatment?
As there is currently no cure for RA, treatment goals centre on disease management. Treatment is aimed at:
- Controlling disease progression
- Providing pain relief and reducing swelling
- Preventing joint damage and deformity
- Maintaining function of the affected joints and preventing disability
What are the medical treatment options?
Depending on the level of severity and stage of the disease, several different types of drug therapies may be used in monotherapy or combination:
- Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
- Analgesic drugs
- Disease Modifying Antirheumatic Drugs (DMARDs)
- Biological therapies.