Rheumatoid Arthritis

 

Rheumatoid Arthritis

  • The Disease
  • Diagnosis & Screening
  • Treatment

The Disease

Rheumatoid arthritis is a chronic, inflammatory autoimmune disease, where immune cells mistakenly attack and destroy healthy body tissue, because they believe the healthy tissue is a bacteria or virus. It is incurable and progressive.

Rheumatoid arthritis is characterised by inflammation of the synovial membrane, which lines the joints and is essential for the protection and lubrication of the bone and helps to ensure joint mobility. Inflammation occurs because the immune cells, which are designed to protect the body, start to attack the joints. The inflammation spreads to the cartilage or bone causing pain, stiffness and swelling, and may eventually result in irreversible bone destruction.

The prognosis for some people with rheumatoid arthritis can be poor, and only a year after diagnosis, one in seven people are no longer able to work. The impact of the disease is shown by work ability figures: after five years 40% of people lose their jobs because of rheumatoid arthritis, three quarters of whom for reasons directly related to their arthritis (Source: Arthritis Research UK).

The final stage of rheumatoid arthritis, characterised by severely deformed wrists and ankles, has become less common due to advances in the diagnosis and treatment of the disease.

Diagnosis & screening

Currently doctors rely on a range of signs and symptoms to make a firm diagnosis of rheumatoid arthritis. They conduct a physical examination, examine the patient’s history and run laboratory tests e.g. test for antibodies to cyclic citrullinated protein (anti-CCP) in blood. Anti-CCP is highly specific to rheumatoid arthritis, so it helps to confirm a diagnosis and can predict the eventual development of rheumatoid arthritis if the patient has arthritis.

However, by the time these signs are obvious many people are already losing mobility in their damaged joints. The ideal time for starting treatment may also have passed; the earlier treatment is started, the better the disease can be controlled.

Treatment

Traditionally, treatment was based on large-scale suppression of the immune system (immunosuppression) and the use of anti-inflammatory agents. Doctors still use a range of these treatments – often in combination with each other or with newer treatments that act on the processes involved in the disease, making it possible to stop or at least slow its progression.

Biological Medication

Biologic medication is designed to affect parts of the immune system that play a role in the disease process of rheumatoid arthritis. This includes IL-6 inhibitor, which inhibits the activity of IL-6, a protein that plays a key role in the rheumatoid arthritis inflammation process.

Selective B cell therapy - initially used to fight a type of blood cancer - selectively intervenes in the molecular course of the disease without weakening the immune system as a whole. This mechanism of action can alleviate pain and also help to hold the disease in check.

Rheumatoid arthritis has no known prevention. However, it is often possible to prevent further damage to the joints with proper early treatment.