Rheumatoid arthritis (RA) is an auto-immune disease, a disease of the immune system, which is the system that protects (immunizes) us against foreign proteins, like germs and transplanted organs. The abnormal state called auto-immunity is analogous to being allergic to one's self, in which the white blood cells and antibodies of the immune system attack one's own organs and tissues. The illustrations show a knee with a large, inflammatory, effusion (fluid in the joint), and a pair of hands with typical, advanced, rheumatoid arthritis.
RA can affect people of any age or either sex. RA can lead to disabling deformities and, in rare cases, even to death. RA frequently leads to osteoporosis and leaves its victims susceptible to infection. However, modern treatment has evolved to a point that is so effective that most patients enjoy remission, which is like a cure as long as medication is continued. It has actually become quite unusual to see the kinds of things illustrated on this page.
The basics of RA treatment include anti-inflammatory drugs, physical therapy, and proper nutrition. Regular monitoring for osteoporosis with DEXA (bone density test) scans is essential. Most patients are also treated with methotrexate, which is capable of inducing remission in many cases.
X-rays should be done to assess the structure of the joints and early, aggressive treatment should be instituted to prevent joint damage. The current standard of treatment usually includes methotrexate, a drug capable of inducing remission and preventing or slowing the rate of joint damage, plus other medications.
In the 21st century we have wonderful new treatments, sometimes yielding real miracles. These new treatments, called BRMs (biologic response modifiers) are the result of recombinant DNA research. BRMs, used either alone or in combination with methotrexate, can make dramatic changes in RA, in many cases leading to complete remission and the ability to decrease or discontinue other drugs. Even the worst cases can sometimes be brought into remission.
RA victims need to be apprised of these advances and need to be seen by rheumatologists, because too many doctors are unaware of the tremendous strides made in recent years. This also includes the ability to deal effectively with side effects and the ability to decrease or eliminate doses of steroids, the cortisone-like drugs so often used in the past. The ACR (American College of Rheumatology) recommends that all patients with RA be seen by a rheumatologist to properly guide treatment before irreversible joint damage occurs.
The pharmaceutical companies have worked long and hard to bring these substances to the public. The Arthritis Center has been in the vanguard of these research efforts and has the necessary expertise to use these drugs safely. We remain committed to the development of essential treatments for arthritis, and always have several research projects in progress, in partnership with the pharmaceutical industry and overseen by the U.S. Food and Drug Administration (FDA). For a more in-depth discussion, go to Infusion Center of Connecticut.