What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Autoimmune diseases occur when an internal attack on the body’s own tissues occurs by their own immune system. The immune system is an organization of cells and antibodies that operates normally to seek and destroy invaders of the body, especially infections. The most prevalent feature of RA is joint pain and disfiguration of parts of the body. RA can cause inflammation of the tissue around the joints, as well as in other organs in the body. Typically, RA will affect the hands, feet and knees, although it has been found in other areas of the body as well. It most often starts after 40 years of age and before 60 years of age. Women seem to more prone to RA than men, up to three times more prone.
Can You Prevent the Occurrence of Rheumatoid Arthritis?
At this time, one cannot prevent the occurrence of RA because the medical reason is unknown as to what causes it. However, there may be genetic factors in play. If RA has occurred in a parent or grandparent, there is a possibility that it may occur elsewhere in the family. However, there is no sexual predetermination such as males get it from males or females get it from females. It may even skip a generation. It has also been found in young people, called juvenile rheumatoid arthritis.
Diagnosis for RA
Understanding RA is complicated, and there is no one medical diagnostic test for exposing the disease. Instead, a diagnosis for RA occurs on a combination of factors such as the presence of blood rheumatoid factor and citrulline antibodies, the presentation of the joints involved, the characteristic effect of joint stiffness in the morning and findings of rheumatoid nodules and X-ray testing.
Medical Treatments of Rheumatoid Arthritis
The standard and typical treatments for RA are disease-modifying antirheumatic drugs. There are two kinds, oral and biologic. Oral drugs, as the name says, are taken orally into the system, while the biological kind are injected.
Commonly used oral DMARDs:
Antimalarials such as hydroxychloroquine ( Plaquenil ) or chloroquine ( Aralen ) are useful for treating several forms of malaria and rheumatoid arthritis. These are prescription drugs. However, the action mechanism is still unknown meaning that it is not clear what makes them work. Leflunomide ( Arava ) reduces inflammation in the joints that is responsible for both the symptoms of rheumatoid arthritis and the destruction of joints. Methotrexate ( Rheumatrex ) is an anti-metabolite drug, which means it is capable of blocking the metabolism of cells and altering the immunity of cells, which is a common problem in RA. Sulfasalazine (Azulfidine) is a pro-drug, meaning that it is not active in its ingested form. The drug becomes active when bacteria in the colon break it down.
Less commonly used oral DMARDs:
Azathioprine such as Imuran is an immunosuppressant. It is a drug that that can suppress the immune system. Cyclophosphamide such as Cytoxan primarily works for treating several types of cancer. But it is also an immunosuppressant drug. Gold salts such as Ridaura or Aurolate are effective treatments for RA. The term describes the ionic chemical compounds of Gold. Medically it is chrysotherapy. Gold salts decrease the inflammation of the lining of the joint this way they prevent the inflammation from destroying the bone and cartilage surrounding the joint. Gold salts also have the moniker as a second-line drug since they become available when other anti-inflammatory drugs make no headway in the treatment of arthritis.
Biological DMARDs:
Abatacept (Orencia ) is a synthetic i.e., manufactured protein produced by recombinant DNA technology. By attaching to the protein, Abatacept prevents the activation of the T-lymphocytes responsible for the arthritis. In patients, T-lymphocytes occur in high quantities within the joints that are inflamed. Abatacept blocks the production of new T-lymphocytes and the production of the chemicals that destroy tissue. Adalimumab (Humira) is an injectable protein that blocks the effects of inflammation caused by the tumor necrosis factor alpha (TNF alpha) in RA. TNF is a normal protein produced by the body when there is inflammation. Normally, the process of inflammation is the body’s reaction to injury and is a necessary process for the repair of the injury. Because TNF promotes inflammation, controlling the inflammation is a way of controlling RA. Anakinra ( Kineret ) is a synthetic drug to blocks the effects of Interleukin-1. Interleukin-1 is a protein produced in many cells of the body with an above average number appearing in the joints inflamed by RA. Etanercept ( Enbrel ) This is another synthetic drug used to block the effects of TNF alpha. It does this by binding itself to the TNF so it acts like a sponge and removes the TNF from the blood and joints. Infliximab ( Remicade ) is another drug used to block the inflammation effects of TNF alpha. Rituximab (Rituxan) can find use when other TNF blockers are ineffective. The effectiveness of rituximab comes from its ability to deplete temporarily the number of B-cells, (cells of the immune system), which are important in promoting inflammation in rheumatoid arthritis.
This quick overview of the medications used in rheumatoid arthritis shows where the focus is for treatment. The effects of inflammation around the joints can be handled with a variety of different drugs acting in different ways.