Monday, December 16, 2013

Rheumatoid arthritis

By Justine Shum, MSIV

Rheumatoid arthritis (RA) is an autoimmune disease that most commonly presents as an inflammatory arthritis affecting the joints. Like many other autoimmune diseases, RA affects more women than men -- about 3x as many women have the disease.

RA is a chronic disease that cannot be cured, but there are now many medications that are effective in reducing symptoms and slowing the progression of the disease. These medications are classified as disease-modifying antirheumatic drugs (DMARDs), and can further be separated into conventional DMARDs such as methotrexate and sulfasalazine, and biologic DMARDs such as rituximab and adalimumab. Because of DMARD use, the severe RA that results in crippling joint deformities is fortunately becoming more rare.

Current recommendations call for treatment with DMARDs to begin once a diagnosis of RA is made. Many patients wish to delay treatment, however, recent studies have shown that early and immediate treatment of RA results in lower disease activity in patients. These studies also show that at 2 years following diagnosis, patients who received immediate treatment were less likely to have joint damage and resultant disability.

Patient education of the disease course of rheumatoid arthritis and the consequences of delaying treatment will likely make the difference in patients who are wavering on initiating DMARDs. See the links below for some basic patient education material provided by the American College of Rheumatology.



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