Rheumatoid arthritis (RA) is an autoimmune disease that mainly attacks the synovial tissues around the joints. Autoimmune diseases cause the body’s immune system to mistake its own tissues for foreign invaders, such as bacteria or viruses. The confused immune system develops antibodies to seek out and destroy the “invaders” in the synovium.
RA is a systemic disease, which means it can affect the whole body. It can attack organs, such as the heart, the lungs, or other tissues like muscles, cartilage and ligaments. RA causes chronic swelling and pain that is sometimes severe, and it can cause permanent disability.
Symptoms and Risk Factors
At the onset of RA, you might notice that small joints like your fingers and toes are warm, stiff, or swollen. These symptoms might come and go, and you may think it’s nothing. RA flare-ups can last just a few days or a few weeks before they disappear again.
Eventually, RA will affect larger joints, such as hips, shoulders, and knees, and the period of remission will shorten. RA may damage joints within two years of onset. Sixty percent of people with inadequately treated RA are unable to work 10 years after onset.
Other symptoms associated with RA include:
- low-grade fevers
- pain and stiffness for longer than 30 minutes in the morning or after sitting
- weight loss
RA can be hard to diagnose because the types and severity of symptoms vary from person to person. They’re also similar to symptoms of other types of arthritis, which makes misdiagnosis possible.
The cause of RA is unknown, but a number of risk factors could contribute, such as:
- lifestyle (ex. smoking)
Out of every 100,000 people, 41 are diagnosed with RA every year. About 1.3 million Americans have RA.
Women are about two-and-a-half times more likely to get RA than men are. Hormones in both genders may play a role in either preventing or triggering it.
RA generally starts between the ages of 30 and 60 in women and somewhat later in life in men. The lifetime risk of developing RA is four percent for women and three percent for men. However, RA can strike at any age—even small children can get it. More than 300,000 children have the juvenile form of the disease.
RA increases the risk of heart disease or stroke, because it can attack the pericardium (lining of the heart). Risk of heart attack is 60 percent higher one year after being diagnosed with RA than it is without the disease.
People with RA may avoid exercise because of joint pain, risking weight gain and placing extra strain on the heart. People with RA are twice as likely to suffer from depression, which may be due to decreased mobility.
The damage RA can do isn’t limited to the joints. The disease also can affect your:
- vascular system
Infections may be responsible for one quarter of deaths in people with RA.
RA can make simple tasks like getting out of bed and getting dressed in the morning challenging, let alone holding down a regular job. People with RA are more likely to:
- change occupations
- reduce their work hours
- lose their job
- retire early
- be unable to find a job (compared to people without RA)
RA costs $5,763 (in year 2000 dollars) per person who has the disease every year. Annual medication costs can reach $15,000 to $20,000 per patient treated with a biologic agent.
In addition to the financial costs of this disease, the cost of quality of life is high. Compared to those without arthritis, people with RA are:
- 40 percent more likely to report fair or poor general health
- 30 percent more likely to need help with personal care
- twice as likely to have health-related activity limitation
RA does not have a cure at this time. Many new treatments have been developed over the last 30 years, but none of them “cure” RA. Instead, they aim to lower inflammation and pain, prevent joint damage, and slow the progression of the disease.
Drugs that treat RA include:
- non-steroidal anti-inflammatory drugs (NSAIDs)
- disease modifying anti-rheumatic drugs (DMARDs)
- biologic DMARDs