Rheumatoid Arthritis (RA)

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disease, which means that that your body attacks healthy tissue. It is a systemic inflammatory disease, which shows up in multiple joints. RA affects joint lining, and occasionally organs. Inflamed joint linings erode cartilage and bone, and can cause deformity in your joints.
The classifications of RA, from most common to least, are:

• Progressive: in which the disease continues to worsen, without pause.
• Polycyclic: in which RA activity levels occur in cycles, and change over time.
• Monocyclic: in which there is only one episode of RA, which typically ends within 2-5 years.  

Aggressive treatment and early diagnosis can cause RA to go into remission.

Facts About Rheumatoid Arthritis

• RA is the most common form of inflammatory arthritis, affecting approximately 1% of the U.S. population.
• Increases risk for heart disease and stroke
• 15,600 hospitalizations in 2004
  • Total cost = $545,000,000
• Average costs = $6777 per year (2 times higher than OA)
• Estimated lifetime cost
  • $122,000 in 1995
  • $186,000 in 2013

Causes

• Although we haven't identified the exact reason for RA, it is thought to be due to a faulty immune response in your body. 

Risk Factors

• Demographics
  • 2-3x higher in women
    • Usually in 40-60's
• Genetics
  • PTPN22 is a possible indicator
• Modifiable
  • Smoking (1.3-2.4x higher risk)
  • Hormone replacement therapy has a mixed association
  • Live birth appears to decrease risks of developing RA
• Women who breastfeed have a lower risk of developing RA
  • Irregular menses or early menopause appear to increase RA risk levels

Symptoms

• In joints
  • Pain
  • Swelling
• Redness
• Low fevers  
• Loss of energy
• Loss of appetite
• Rarely
  • Dry eyes (sometimes Sjogren's syndrome)
  • Firm lumps (rheumatoid nodules) underneath skin in elbows and hands. 

Treatments

• There is no cure for RA, but it can be managed.
  • Ideal diagnosis and aggressive treatment work best when started within six weeks from onset
• DMARDs (Disease-Modifying Anti-Rheumatic Drugs) have proven effective recently
  • Best treatments appear to be a combination of biological agents (like DMARDs) and methotrexate.
• Consult your local rheumatologist

Resources

The CDC has more detailed information on rheumatoid arthritis.