|
Author: Nathan Wei Article source: http://www.all-health-4u.info/. Used with author's permission.
RA is a condition that forces half of patients to become disabled from the work force within five to ten years… and reduces life expectancy by as much as 18 years. RA affects about one per cent of the world's adult population, most commonly women between the ages of 30 and 50.
The good news is that a tremendous amount of progress has been made within the last ten years in identifying patients earlier and treating the disease more aggressively. Patients with RA, if treated appropriately, can lead a relatively normal life. This is in stark contrast to the wheel-chair bound existence common as recently as 20 years ago!
Experts in the field consider early rheumatoid arthritis to be a medical emergency with mortality and morbidity equal to that for diabetes, asthma, heart disease, and other life-threatening conditions.
Rheumatoid arthritis attacks the joints in a symmetric fashion (both sides of the body affected equally) with the most common areas being the hands, wrists, ankles, knees, and feet. In addition to the swelling and pain, patients with RA often have profound fatigue and stiffness.
Rheumatoid arthritis is an autoimmune disease that attacks not only joints, but internal organs such as the blood vessels, lungs, heart, and eyes. Patients with RA are at increased risk for heart attack, stroke, and lymphoma.
Since many other types of arthritis such as gout, lupus, and osteoarthritis can look like RA a careful diagnostic approach is needed.
Laboratory testing has its pitfalls. The rheumatoid factor, a blood test found to be positive in about 80 per cent of individuals with RA, may also be positive in other disease conditions. Couple that with the fact that 20 per cent of patients with RA will be rheumatoid factor negative, then it becomes clear a diagnosis should not hinge on the results of blood tests alone.
Imaging procedures can also be misleading. Conventional x-rays often miss the erosions found with early disease. Newer imaging technologies such as magnetic resonance imaging (MRI) and ultrasound are much more sensitive.
After the diagnosis is made, there is even more hope for a patient today. In the past, non steroidal anti-inflammatory drugs (NSAIDS) used to be considered a cornerstone of therapy. That is no longer true.
Disease-modifying anti-rheumatic drugs (DMARDS) are being used earlier.
Among the DMARDS currently being used are methotrexate, leflunomide (Arava), azathioprine (Imuran), sulfasalazine (Azulfidine), cyclosporine, and hydroxychloroquine (Plaquenil). These drugs attack the immune cells responsible for chronic inflammation. While DMARDS alone in combination are effective, they are relatively non-specific. Often, combinations of DMARDS are required.
Biologic Response Modifiers (BRMS) can target the disease more specifically than DMARDS. RA is a disease that is dependent on the signaling that occurs between immune cells. The signaling takes place through the use of special chemical messengers called cytokines. BRMS act at both the cytokine (chemical messenger) as well as the cellular level allowing the disease to be better controlled and in some instances put into remission.
Biologic response modifiers, which include drugs that suppress tumor necrosis factor (TNF), appear to be particularly effective.
Tumor necrosis factor is a protein that is produced by the immune cells. TNF is the major culprit responsible for inflammation-inducing damage. By block the effects of TNF, better control of RA can be achieved.
Three anti-TNF drugs are currently available: etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade). Another biologic drug, anakinra (Kineret) blocks interleukin, a different cytokine.
These drugs allow patients to have their disease controlled to such an extent that most are able to enjoy a normal work and leisure existence.
On the horizon are other biologic drugs that work at different points in the immune system- on different cytokines and on different pathways- to allow even greater as well as more specific control of disease. Since rheumatoid arthritis is a disease with many different cytokine and cellular mechanisms responsible for damage, attacking the disease at different points makes sense. In the future it may be possible to identify patients through specific tissue signals (called "biomarkers"). These biomarkers will allow physicians to type patients and give patients the specific therapy that will work best for them. Once that is achieved, the possibility of a cure becomes a reality.
Everything, though, starts with early accurate diagnosis. If damage is allowed to occur the chances for remission drop dramatically! Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com
The Six “F” Words Every Entrepreneur Should Know
Start your own business, and soon enough, you find yourself in a situation
where there are many things you want to say, all of them unprintable.
Everything About Zone Diet
The article explains what a zone diet is and its history. It also deals with the importance of zone diet and how it is different from the other forms of dieting...
The Power You Possess
What you need to understand is that there is no barrier to what is possible. It doesn't matter what it looks like. Everything that you desire is possible. Eve...
Gay Breakups: When the Rainbow Ends
This article will explore the grieving process as it applies to gay relationship breakups and will offer coping tips for managing this often difficult transitio...
The Dark Side of The Pope
"The Pope was the leader of the Roman Catholic Church and represents the Dark side of the Church as well as the brighter side." As the world eulogizes the recen...
Slogans: Creating and Using Them In Life, Career and Business
Marketing coach, Catherine Franz, shares with you all the
how-tos in creating slogans for your life, your career,
and your business.
Complacency Indicator
If you haven't heard of the technical indicator with the stock market symbol VIX it is now time to pay some attention to it. When the number is running low, as ...
Boost Your Online Dating Profile Traffic - Now
There are more than few ways to beef up the attention that your online dating profile is getting. One stands out above the rest. You can easily increase the amo...
Stake Your Ground with a Tailgating Flagpole
Tailgating flagpoles are the perfect way to boldly stake your territory and show your true colors at your next tailgating party, camping trip, family reunion, p...
Nutritional Supplements: The Amazing Benefits of Vitamin E
The real benefits of Vitamin E may surprise you. From heart disease to Alzheimer's, Vitamin E gets the thumbs-up!
Public Relations Primer, Part II: Five Dos
t its core, public relations is about selling. What you sell is your story, and your customers are reporters. Publicity guru Ned Steele shows how to package y...
Summer Lawn Care Tips
Summer is just around the corner, and your lawn could probably use a little maintenance before the summer season of backyard BBQs and swimming in the pool. So ...
13 Tips For Good Search Engine Placements
The following tips and methods are used by the best SEOs to increase their website's search engine rank...
Cell Phone Dos And Dont During A Meeting
What would we do without our cell phones? Wow, there's a scary question. It's hard to imagine a world without them. But cell phones, connected as they may kee...
Furniture Slipcovers
Slipcovers: fashionable and fun!
What is a Personal Life Coach?
A personal life coach demystifies one of the newest and fastest-growing professions in the U.S., and one that increasing numbers of people are using to make rea...
Choosing the Perfect Jogging Stroller
Tips to help decide which jogging stroller is best for your needs.
Green Thumb Not Required
Soy candles can bring your favorite garden scents indoors all year long. There are many floral, herb and fruit fragrances from which to choose.
Employee Motivation - The 8 Basics
To motivate your employees, it is vital that you start off with understanding that there are some things that need to be fixed first, before you can get on with...
Focusing Your Marketing Efforts
There are so many different ways to promote your company -- and you can pour a lot of time and energy (not to mention money!) into marketing without really gett...
Pivot Points in Forex: Mapping Your Time Frame
It is useful to have a map and be able to see where the price is relative to previous market action. This way we can see how is the sentiment of traders and inv...
Students Searching for a Job
Looking for a job after finishing school marks a major event in a student's life.
Outdoor Cedar Patio Furniture Goes Indoors!
Most assume that the increase in Cedar Patio Furniture Sales over the last few years is due to the hot new trend towards building "Garden Rooms". But there's a...
What Love and Money Have in Common
The 4 simple strategies that are equally effective for wealth and love creation.
|
Print this page