The most important advances in treatment in the last 25 years have been the use of methotrexate as a disease modifying anti-rheumatic drug (DMARD) and the use of biologic therapies to get this disease into remission.
Before discussing therapy, it is critical that a rapid, accurate diagnosis of RA be made as soon as possible. This is because the damage to both joints as well as internal organs may occur early in the course of illness.
Newer laboratory tests such as the anti-CCP as well as imaging techniques such as magnetic resonance imaging and diagnostic ultrasound have made the diagnosis easier.
A recent study has demonstrated that patients with shorter duration of disease and less severe disability are increasingly being treated with biologic therapies. (Soderlin MK, et al. (Ann Rheumatic Dis. 2008; 67:37-42).
Why is this approach a good one?
Another recent study has demonstrated that TNF-inhibitors, the first line biologic therapies used disrupt the architecture of structures in the lymph system called germinal centers, which are a type of training ground for immune cells.
Normally, the structures help when the host is ill from an infection. The structures swiftly churn out lots of B cells, which the body uses to destroy invaders.
In healthy people, once an infection is beaten off, the germinal centers fade away. But in people with a chronic autoimmune disease like rheumatoid arthritis, these germinal centers continue to train immune cells to become autoimmune attackers.
A team of researchers from the University of Rochester found that anti-TNF compounds inhibit the function and organization of cells known as follicular dendritic cells, which help form the germinal centers.
Follicular dendritic cells have long tentacles that lock onto B cells and hold them in place during their training.
The researchers found that the anti-TNF medication dropped the percentage of B cells in the lymph tissue by about 40 percent in patients. They also found that arthritis patients who received anti-TNF therapy had about one-quarter the number of germinal centers as other arthritis patients. The germinal centers that did exist in patients were smaller and less organized.
TNF, a chemical messenger that stimulates the immune system, is an important trigger for diseases like rheumatoid arthritis. In fact, TNF inhibitors such as Enbrel, Humira, and Remicade have been extremely effective in inducing remission in most patients with RA.
More recently, a drug known as rituximab that targets B cells was approved in 2006 to treat rheumatoid arthritis. The effectiveness of that drug against rheumatoid arthritis supports the findings of the Rochester team and shows how both TNF inhibitors as well as B-cell therapies may have complementary roles in treating RA.
The upshot of the recent research is that:
• RA needs to be diagnosed early
• It needs to be treated aggressively by a well-trained rheumatologist
• No one drug will be effective for every patient and that different approaches may be required. That is why an expert needs to be consulted.
Osteoarthritis And Rheumatoid Arthritis
Rheumatoid arthritis is inflammatory and chronic in nature and will result in the malfunction of the autoimmune, causing the immune system to attack the joints and will lead to pain, inflammation as well as limiting mobility. It is a universal condition that cause the extra-articular tissues in the body, for instant the lungs, blood vessels, muscles, skin in addition to heart to malfunction
As it is chronic in nature, it will be with the sufferers for years and there are times where there is no known symptom. The disease is risky in nature as it can lead to the damage of the joints in addition to functional disability. The symptoms are stiffness, swelling and pain that form on the joints tissues such as muscles, ligaments in addition to tendons.
Rheumatoid arthritis is known to afflict two million Americans and female will get it in the ratio of three to one as compared to male. It usually starts at the age of forty and no racial bias but anyone at any age can get it. Studies have shown that it could be genetic as well.
Infectious agents such as bacteria, fungi as well as viruses can cause it but not proven yet. Environmental factors such as smoking increase the risk of getting rheumatoid arthritis. It can be active when the body tissues are inflamed and submerged when the inflammation is gone.
Some of the symptoms of rheumatoid arthritis are loss of appetite, low-grade fever, stiffness, fatigue in addition to joints and muscles aches. The conditions can spread to other parts of the body, such as organs, besides the joints. To deduce that it is rheumatoid arthritis, stiffness, occurring in the morning should last for more than an hour and there is pain in addition to swelling for more than six weeks. Most likely, you will feel discomfort in both hands and feet.
The physician will diagnose rheumatoid arthritis through a look at the patient medical history, a closer look at the joints for deformity and inflammation as well as looking out for nodules in the skin and inflammation on other parts of the body. As there is no cure for rheumatoid arthritis yet, the aim is to reduce the pain and inflammation to the joints as well as ensuring mobility and at the same time, prevent further damage and deformity to the joints.
Besides affecting adults, rheumatoid arthritis will afflict juvenile too and it is known as Still's disease, which is a cluster of diseases that causes chronic joint inflammation. It can be identified when there is joint stiffness for more than six weeks occurring in a child less than sixteen years old. Juvenile rheumatoid arthritis can spread to the internal organs as well
The genetic makeup as well as the environment is thought to cause rheumatoid arthritis. Telltale symptoms are morning limp as a result of infected knee as well as high fever plus skin rashes. They can rapidly appear and disappear. Certain instances, heart as well as the lungs can be affected.
The treatment for rheumatoid arthritis in children will include a pediatric rheumatologist who can both handle the complexities of pediatrics in addition to rheumatology. Their aims are to provide good quality of life by providing social as well as physical functioning. To achieve that, medications as well as physical therapy are required.
Rheumatoid arthritis will limit mobility as well as causes pain, inflammation, swollen glands, paleness and deformities of the feet and hand. If there are numbness or tingling as well, there is a need to seek the counsel of a physician as timely and the proper diagnosis will lead to early treatments that will prevent further deterioration.
Gold salts can be used to treat rheumatoid arthritis and they can be consumed orally or through intramuscular injections. Gold salts were used way back in 1929 to reduce inflammation in addition to slowing the progress of the condition and also in industrial processes since 1800. Gold salts are effective because it reduce inflammation of the joints.
In using gold salts, intramuscular injections are more effective than taken orally. They are also used to treat children with juvenile idiopathic arthritis. The injections are done every week for up to five months before slowing down and there is evidence to suggest that gold salts for rheumatoid arthritis taken intramuscularly assist in reducing the condition in addition to the inflammation of the joints while oral consumption is less effective.
Although up to now, the reason how gold salts for rheumatoid arthritis work, it is effective but be aware that there will be side effects when gold accumulate in the body. Side effects can range from nausea, diarrhea, skin, kidney and blood problem in addition to lungs, but rarely and skin rashes and mouth sores as well. As gold salts for rheumatoid arthritis can be costly, you need to weigh it carefully.
Both Nathan Wei & Cindy Heller are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Nathan Wei has sinced written about articles on various topics from Arthritis Pain, Health and Arthritis Signs. Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:. Nathan Wei's top article generates over 550000 views. to your Favourites.
Cindy Heller has sinced written about articles on various topics from Network Marketing, Finances and Jewelry. Cindy Heller is a professional writer. Visit to learn more about. Cindy Heller's top article generates over 368000 views. to your Favourites.
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