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Rheumatoid Arthritis Factsheet

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease meaning that the body’s immune system, which usually fights infection, attacks the host. This causes inflammation of the joints and normally affects the wrists, fingers, thumbs, feet and ankles causing pain and swelling but can also affect the entire body.1,2

How is it caused?

The exact causes of RA are still unknown. Physicians have pointed to genetic causes contributing to RA but this does not necessarily mean that if you have a family member living with RA that you will develop the disease. Research also suggests that environmental factors such as certain bacteria or viral infections can lead the immune system to attack the joints, which can lead to RA.2,3

How common is it?

RA affects 580,000 people in England, which suggests that over 690,000 adults in the UK live with the condition.4 In Ireland, 40,000 people live with RA.5 RA affects women three times more than men, starting most commonly amongst adults between the ages of 40-60 although it can occur at any time during a person’s life.4

What are the symptoms?

The symptoms of RA will vary according to each patient and some patients may experience more symptoms than others. The most common symptoms of the disease are listed below:4

  • loss of weight
  • fatigue
  • swelling of the joints
  • the feeling of having flu-like symptoms
  • morning joint stiffness
  • pain

Patients often experience symmetrical symptoms, whereby any symptoms felt on one side of the body are reflected in the same joints on the other side.4 In addition, some patients may experience the effects of inflammation in areas other than the joints, including eyes, lungs, heart and skin. The impact of such symptoms can cause difficulty for patients in carrying out day-to-day activities. In severe cases, RA can lead to disability which could result in unemployment and loss of independence for the individual concerned. For example, among people who have given up work or retired early because of their RA; over a quarter (28.4%) had to stop working within one year of diagnosis, and over half (59%) within six years.6 These factors can lead to psychological effects including anxiety and depression, thus making RA a truly debilitating disease.4

 

How is rheumatoid arthritis diagnosed?

RA is often difficult to diagnose as symptoms such as joint stiffness and pain are also commonly associated with other conditions. In fact many of the characteristic features of RA may not become apparent in the first 1 to 2 months of the disease. Correct and timely diagnosis is very important, in order to limit damage. To facilitate this process, physicians use a combination of diagnostic tools.7

  • Medical History - to determine any possible disease triggers and likely degree of disease onset
  • Physical Examination - to assess the current rate of disease progression and joint involvement#Blood tests including:

- Erythrocyte sedimentation rate (ESR) – to assess the level of inflammation in red blood cells

- C-reactive protein (CRP) – to assess inflammation in any part of the body by checking CRP in the blood

- Full blood count – to assess the amount of red blood cells and rule out the possibility of anaemia

- Rheumatoid factor – to assess the presence of the antibody - rheumatoid factor in the blood

  • Joint imaging

- X-rays, ultrasounds or magnetic resonance imaging (MRI) scans are carried out to assess joint damage

Is rheumatoid arthritis treatable?

  • Whilst a number of treatments exist to help patients manage RA, no cure exists for the disease. Treatments for RA aim to:4
  • Control disease progression
  • Provide pain relief and reduce swellingPrevent joint damage and deformity
  • Maintain function of the affected joints and prevent disability
  • Prevent systemic complications associated with RA

Types of treatment:

Depending on the severity and stage of the disease, several different types of drug therapies may be used in monotherapy or in combination:4

  • Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Analgesic drugs
  • Corticosteroids
  • Disease Modifying Antirheumatic Drugs (DMARDs)
  • Biological therapies

References

1. Karopka T et al. The Autoimmune Disease Database: A dynamically complied literature derived database BMC Bioinformatics 2006; 7:235.

2. National Health Service online http://www.nhs.uk/conditions/Rheumatoid-arthritis/Pages/Introduction.aspx (accessed May 2012)

3. Arthritis Research UK. What Causes Arthritis?
http://www.arthritisresearchuk.org/arthritis-information/conditions/arthritis/causes.aspx (accessed August 2012)

4. National Rheumatoid Arthritis Societyhttp://www.nras.org.uk/about_rheumatoid_arthritis/what_is_ra/what_is_ra.aspx (accessed May 2012)

5. Arthritis Ireland. Arthritis Facts. http://www.arthritisireland.ie/go/about_arthritis/arthritis_facts (accessed October 2012)

6. National Rheumatoid Arthritis Society. Employment and rheumatoid arthritis: A national picture. National Rheumatoid Arthritis Society Survey 2007.

7. NICE. Rheumatoid arthritis. The management of rheumatoid arthritis in adults. NICE clinical guideline 79. 2009.


Oct 2012 - UK/12CI0087