Rheumatoid Arthritis

Rheumatoid arthritis is a frightful inflammatory disease. Though there is no cure, its treatment marks a victory for modern medicine.

Treatment for rheumatoid arthritis has come a long way.

“It’s not the same disease as it was 20 years ago,” says Dr. Yusuf Yazici of the New York University Hospital for Joint Disease. “You don’t see people with crippled hands and feet, and the number of joint replacement surgeries continues to decrease. There used to be 10 patients in a hospital at any given time with uncontrolled rheumatoid arthritis—we have very, very few now. We realized we had to treat patients early in the disease, and aggressively.”

For most patients, an ongoing course of medication can control all the symptoms and essentially put the disease into remission. The leading treatments today are DMARDs, or disease modifying anti-rheumatic drugs.

Rheumatoid arthritis is an autoimmune disease.

Autoimmune diseases are characterized by a malfunction of the immune system; for reasons unknown, the immune system launches an attack on healthy tissue as if the tissue were a foreign body. In rheumatoid arthritis, tissue in the joints—ligament, tendons, muscle—is attacked and becomes inflamed. Resulting symptoms include painful and inflamed joints (especially small joints in the hands and feet), fatigue and stiffness. Rheumatoid arthritis exists in about 1 percent of the population worldwide and affects women two to three times more often than men.

Risk to major organs increases with rheumatoid arthritis.

Just as the misdirected immune system targets joint tissue, it also turns on blood vessels. The inflammation of blood vessels, or vasculitis, is especially dangerous because vessels carry blood throughout the body: to the brain, lungs, skin, kidneys, heart … everywhere. For this reason, rheumatoid arthritis is not just a condition of the joints but a systemic disease. At its worst, the vasculitis resulting from rheumatoid arthritis can lead to stroke, heart attack or the breakdown of other organs.

The disease provides yet another reason not to smoke.

The precise link between rheumatoid arthritis and cigarette smoking is not yet known. However, several studies provide evidence that long-term smoking contributes to the immune system’s malfunctioning, because the effects of the habit impair an already compromised system. This most likely explains why smoking is associated with increased activity and severity of the disease.

Rheumatoid arthritis, when unchecked, is very aggressive.

Says Dr. Yazici, “If untreated, it shortens your life an average seven to eight years. It increases heart disease. Sixty percent of untreated patients are disabled and dependent on others to take care of them within 10 years. But the treatments work. We have better medicines now, and we know how to use them.”

To learn more about rheumatoid arthritis, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases and download its Handout on Health. Also search our articles here at MSN Health & Fitness. Additional information and resources can be accessed through these sources:

• American Academy of Orthopaedic Surgeons
• American College of Rheumatology
• Arthritis Foundation

Thank you to Dr. Yusuf Yazici, Assistant Professor of Medicine at NYU Hospital for Joint Diseases for his background and guidance.

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• The Mystery of 'Weather Knees'
• Arthritis Message Board