Rheumatoid Arthritis is an autoimmune disease that is commonly associated with aging. The body’s immune system mistakenly attacks joints which leads to inflammation and varying levels of severity. For many patients, Rheumatoid Arthritis (RA) starts with mild joint pain in their hands and feet, some swelling, and morning stiffness.Eventually, the pain and stiffness increases, and becomes more and more persistent. Luckily, there are treatments available to help alleviate symptoms.
For those who have RA, early and aggressive management of the disease is critical. Studies have shown that patients who receive treatment earlier do significantly better than those whose treatment is delayed.
The good news is that treatment advances have made it possible to arrest or at least slow progression of the disease. Rheumatologists, who specialize in autoimmune diseases like RA, now have the medications and the understanding to treat the inflammation that causes it and eliminate or limit the pain and dysfunction.
RA affects an estimated 1.3 million adults in the U.S., 75 percent of which are women. It’s a chronic disease that if not treated can sometimes affect other organs, like the eyes, heart and lungs. Additional symptoms can include loss of energy and appetite and low grade fevers. Patients with untreated, or inadequately treated RA, live shorter lives and are at high risk for heart attack or stroke. They carry an increased risk of cardiovascular disease equivalent to diabetic patients.
While the disease can begin at any age, the peak is between the ages of 40 – 60 and is usually diagnosed by conducting a physical exam and blood test. X-rays can also be used, but are most useful in monitoring the disease’s progression.
In most cases, treatment can relieve patients’ pain and keep them functioning at near or normal levels. And while there is no cure, many achieve remission where there are no signs of disease.
The caveat, however, is that for most patients the treatment may need to change during their lifetime. This requires frequent evaluation for medication effectiveness, side effects, and resulting symptoms. Symptoms can vary widely and change over time. This is why RA needs to be carefully managed and monitored through the use of blood work and imaging studies, such as x-rays, ultrasounds, nuclear scans and MRIs.
Treatment usually begins with the use of conventional disease-modifying anti-rheumatic drugs (or DMARDs). These drugs not only relieve symptoms, but also slow the progression of the disease. They are taken orally either alone or in combination of two or three drugs. Non-steroidal anti-inflammatory drugs (or NSAIDs) and/or low-dose corticosteroids are often also required. Steroid use can’t be prolonged because of their side effects that can include weight gain, diabetes, cataracts, bone loss, cardiovascular disease and severe infections.
Patients with a poorer prognosis or who fail to respond to the initial therapy with conventional DMARDs may be given medications called biologic DMARDs. These drugs target the parts of the immune system and signals that lead to inflammation and joint and tissue damage. Physical therapy may also be recommended.
Most importantly, patients with RA need to start treatment early and work with physicians who specialize. With today’s treatments, patients who are managed well can live normal and active lives. If you have any questions or concerns, don’t hesitate to reach out to your doctor.