What is Rheumatoid Arthritis?
Advisory by Marcus Heng, Guardian Pharmacist
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by the body's immune system attacking itself. This differs from osteoarthritis (OA), which primarily involves wear and tear of joints, and does not involve the immune system. The exact cause of RA is unknown, but majority of sufferers are female.
What are the symptoms of RA?
RA typically affects the joints, progressively leading to bilateral deformities and erosion of cartilage and bone if left untreated. Smaller joints are most affected, becoming red and swollen with morning stiffness. Unlike OA, RA may also cause fatigue, low-grade fever, dry eyes and the formation of nodules.
How is RA managed?
There is no cure for RA, but with adequate management of the disease, symptoms can be controlled.
Disease-modifying anti-rheumatic drugs (DMARDs) or biologic medicines are typically started early to suppress the immune hyperactivity in RA. Next, anti-inflammatory painkillers and corticosteroids may be used to bridge the therapy till the DMARDs take effect. As DMARDs and biologic agents affect immunity, certain vaccinations should be taken before the initiation of drugs. Blood count should also be monitored frequently throughout therapy.
Intrasynovial steroid injections may be indicated for severe symptoms in larger joints, but are less favored due to the risk of infection or further joint damage.