Facts About Rheumatoid Arthritis

Knowing the signs of Rheumatoid Arthritis can avoid permanent disability

/ Author:  / Reviewed by: Joseph V. Madia, MD

New rheumatoid arthritis drugs are on the horizon, both in clinical trials and the lab. What does this mean for people who live with RA?

Pfizer successfully completed human trials for tofacitinib (formerly tasocitinib), a drug that was shown to improve symptoms in patients who were previously unresponsive to current RA drugs and treatments. The trial showed that tofacitinib has the potential to help people who don’t get relief from other RA drugs like Humira, Enbrel, and Remicade, because it relieves RA symptoms just as well as the other drugs do.

On the discovery side of things, researchers at New York University discovered that a protein called progranulin significantly reduced and in some cases eliminated symptoms of rheumatoid arthritis in lab mice. They later isolated the key parts from progranulin into a new molecule they called ATSTTRIN, that worked even better, and for the best news, the researchers suspect that ATSTTRIN will be much cheaper than current RA therapies.

Most importantly, however, is the new research that strongly suggests that getting early treatment of rheumatoid arthritis may prevent permanent disability. Researchers at the University of California at Los Angeles discovered that patients who started treatment in the first five years of diagnosis had a significantly greater chance at remission than patients who waited longer. Therefore, it is important to be able to identify the signs and symptoms of rheumatoid arthritis. Let's take a look at some things you and your family should know

What does "Rheumatoid" mean?

The word “rheumatoid” means that this type of arthritis is due to an autoantibody called rheumatoid factor (RF). So, in rheumatoid arthritis an antibody made by the body works against itself rather than foreign bacteria.

Are all types of arthritis the same?

Arthritis, as a general term, is any kind of inflammation of a joint. Septic arthritis, for example, is when there's a bacterial infection in a joint (which is quite dangerous and needs immediate medical care. In the case of more general, chronic arthritis, people may confuse rheumatoid arthritis with osteoarthritis.

In rheumatoid arthritis, the body has a chronic immune response against itself and attacks the joints, with pain in the hands, feet, and neck. It can happen in the shoulders and knees as well. The pain is usually symmetrical (on both sides of the body), and is characteristically worst in the morning, with stiffness in the joints lasting up to an hour after waking up. Osteoarthritis (OA), on the other hand, is not an autoimmune disorder. Experts are mostly in agreement that mechanical stress, or, the 'wear and tear' of daily living is ultimately responsible for causing the degradation of joint cartilage.

What are the symptoms of rheumatoid arthritis?

The disease actually often starts as a flu-like condition, as many patients experience feelings of fatigue, low fevers, weakness, swollen glands, and loss of appetite. Soon enough, the disease will reveal itself as RA when the joint pain starts, with the morning stiffness being the hallmark factor. Again, joint pain is symmetrical in the fingers, wrists, ankles, and sometimes knees and shoulders, and they will feel swollen, warm and boggy. Some patients experience bumps on their skin called rheumatoid nodules, often near the elbows. This symptom, unfortunately, means the RA is a very sever case. In some cases, people will experience inflammation of the kidneys and heart, in the forms of amyloidosis and pericarditis, respectively. Also know that women are three times as likely to be diagnosed with RA.

I've been diagnosed, what do I do?

After the x-rays, blood tests, and clinical symptoms have all pointed towards RA, treatment is usually started with DMARDS, which is a fancy acronym for “disease-modifying antirheumatics.” Methotrexate is usually used in combination with hydroxychloroquine (Plaquenil) or sulfasalazine. Other agents fall into the category of biologics, many of which block the inflammatory molecule TNF-alpha. The commonly prescribed drugs are Enbrel, Remicade, Humira, and Simponi, as well as a host of other immune modulating drugs.

Now what?

Rheumatoid arthritis can affect people in many different ways-- some people have very few symptoms while some people unfortunately experience crippling disability. The best thing you can do is look at your family history, as that's the most important risk factor. If you have family members with RA, let your doctor know. Also, there's strong evidence that smokers are at up to three times greater risk for developing it, especially men...so quit already! Take heart that new drugs and new evidence are pointing towards an easier road for RA patients, and the sooner you start treatment, the better your life can be.

Review Date: 
March 14, 2011