Specialty Pharmacy
Rheumatoid Arthritis
What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. This creates inflammation that causes the tissue that lines the inside of joints (the synovium) to thicken, resulting in swelling and pain in and around the joints. The synovium makes a fluid that lubricates joints and helps them move smoothly. Rheumatoid Arthritis is a chronic disease that causes joint pain, stiffness, swelling and decreased movement of the joints. Small joints in the hands and feet are most commonly affected. Sometimes RA can affect your organs, such as eyes, skin or lungs. RA is the most common form of autoimmune arthritis.
Symptoms
The joint stiffness in active RA is often the worst in the morning. It may last one to two hours (or even the whole day). It generally improves with movement of the joints. Stiffness for a long time in the morning is a clue that you may have RA, as this is not common in other conditions. For instance, osteoarthritis most often does not cause prolonged morning stiffness.
Other signs and symptoms that can occur in RA include:
- Loss of energy
- Low fevers
- Loss of appetite
- Dry eyes and mouth from a related health problem, Sjogren’s syndrome
- Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands
Treatment
There is no cure for RA. The goal of treatment is to improve your joint pain and swelling and to improve your ability to perform day-to-day activities. Starting medication as soon as possible helps prevent your joints from having lasting or possibly permanent damage. No single treatment works for all patients. Many people with RA must change their treatment at least once during their lifetime.
Medications
The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you’ve had rheumatoid arthritis.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.
- Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.
- Biologic agents. Also known as biologic response modifiers is a newer class of DMARDs These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate.