Rheumatoid arthritis, or RA, involves inflammation in the lining of the joints and/or other internal organs. RA typically affects many different joints. It can be chronic or can be a disease of flares and remissions.
- Rheumatoid arthritis affects 2.1 million Americans, mostly women
- Onset is usually in middle-age, but often occurs in the 20s and 30s
RA, which affects the entire body, is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement.
The cause of rheumatoid arthritis is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage. Researchers suspect that virus-like agents may trigger RA in some people who have an inherited tendency for the disease. Many people with RA share a certain genetic marker.
Highly effective drug treatments exist for rheumatoid arthritis. Early treatment is critical. Current treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being. Medications can be divided into two groups:
- Symptomatic medications, such as NSAIDs and aspirin, analgesics, and glucocorticoids, help reduce joint pain, stiffness and swelling. These drugs may be used in combination.
- Disease-modifying medications include low doses of methotrexate, leflunomide, sulfasalazine, azathioprine, hydroxychloroquine, and cyclosporine.
- Newer biologic therapies include infleximab, etanercept and adalimumab.
In addition, treatment most often involves some combination of exercise, rest, joint protection, and physical and occupational therapy. Surgery is available for joints that are damaged and painful.