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[R314]Rheumatoid Arthritis Cervical Spine

by George Harper, Geo

You might not know it, but you could be suffering from rheumatoid arthritis. Although rheumatoid arthritis is commonly associated with the older generation (people over the age of 65), the disease is found in younger generations - even including children. How could you tell if you have it? Well if you're experiencing morning stiffness for no apparent reason (like if you had done a lot of strenuous exercise the night before, for example), you might be suffering from one of it's symptoms. As mild as you might think morning stiffness is, you really ought to give it some serious thought and consult with your doctor because if that morning stiffness is related to rheumatoid arthritis, you can work to prevent it from disabling or crippling you later on down the road to a point where you can barely function. But rheumatoid arthritis isn't just a physical condition. It has the propensity to tax your mental and emotional state of well-being tpp.

This is because arthritis can change the way you work, the way you interact with your family, and the way you entertain yourself with recreational activities. You might even know someone with rheumatoid arthritis and have observed how this disease changed not only his or her mobility, but also his or her outlook on life. Those of us without rheumatoid arthritis tend to take our ability to move anyway we want for granted, but when that ability slowly disappears right before our eyes, it's no surprise that we get depressed about it.

But it doesn't necessary have to be that way. With proper medications, education, support, and prescribed exercises, you could work to prevent the most severe forms of the disease - or at least prolong the worst case symptoms.

Arthritis works in two ways. First, it inflames the muscles, ligaments, and cartilage that sit in-between joints. And it's this inflammation that causes the pain, swelling, and heat. Those are symptoms that are typical indications of an injury and they're vital to understanding more about this disease. Second, arthritis works by releasing enzymes that basically consume or otherwise destroy the muscles, ligaments, and cartilage that have become inflamed to a point where they're not very useful and don't allow for easy movement. In the worse cases, cartilage disappears completely and as you can guess, this is extremely crippling and uncomfortable.

That's why we call rheumatoid arthritis a disease. Typically, inflamed muscles, ligaments, and cartilage are the result of an injury, like falling on the knees for example. But with arthritis, no injury has to occur. In fact, arthritis is a type of autoimmune disease and the cartilage inside joints is one of the things that it destroys. And any joint can be affected - one, two, maybe even more but most of the time, the disease targets fingers, hips, feet, and knees.

George Harper writes for where you can find out more about .

Medications that block tumor necrosis factor alpha (TNF-a), a pro-inflammatory cytokine important in the pathogenesis of RA, were among the first to be developed and approved for the treatment of RA. Several anti-TNF-a medications including Enbrel, Humira, and Remicade are currently marketed for the treatment of RA.

Actemra (tocilizumab) differs from currently marketed biological response modifiers that block TNF-a, since it targets interleukin-6 (IL-6), a cytokine that is also over-produced in the joints of RA patients.

Il-6 is believed to contribute to inflammation, swelling and joint damage and possibly the anemia and platelet elevation counts seen in RA.

Actemra is a humanized anti-human IL-6 receptor monoclonal antibody that works by competitively blocking the binding of IL-6 to its receptor. In essence, it inhibits the deleterious effects of IL-6, which lead to inflammation and proliferation of inflammatory cells and the destructive organ potential in RA.

Multiple clinical trials have examined the efficacy and safety of Actemra.

The largest of these trials was the OPTION (TOcilizumab Pivotal Trial in Methotrexate Inadequate RespONders), a three-arm, randomized, double-blind, controlled study designed to compare the safety and efficacy of Actemra plus methotrexate with methotrexate plus placebo in RA patients who had an inadequate response to methotrexate alone.

Results from the OPTION trial demonstrated that rheumatoid arthritis (RA) patients not only achieved greater improvement of symptoms but also a higher quality-of-life with Actemra compared with methotrexate, a commonly used RA treatment.

In the OPTION trial, which was a three-arm, double-blind, controlled Phase III study, 623 patients were randomized to receive Actemra intravenously (either 4mg/kg or 8mg/kg) every four weeks plus methotrexate weekly or placebo infusions plus methotrexate weekly. The study was conducted in 73 trial sites in 17 countries outside the United States.

A rapid decrease in disease activity was seen as early as two weeks in a greater proportion of patients treated with Actemra plus methotrexate, with 27.5% achieving clinical remission by 24 weeks.

Additionally, results showed that 80% of patients in the Actemra plus methotrexate group responded with moderate to good improvements in RA symptoms, compared with 35% for those treated with placebo and methotrexate at 24 weeks.

The OPTION trial also assessed physical function and quality-of-life at baseline and every four weeks thereafter. Patients receiving Actemra achieved significantly greater improvement in areas of fatigue and mental function at 24 weeks, and achieved normal levels of hemoglobin (red blood cell count)and C-reactive protein (CRP), a marker of inflammation due to RA, compared with patients receiving placebo plus methotrexate. In addition, platelets, blood cells that often increase in number during the inflammation that accompanies RA, seemed to drop as well.

According to Dr. Nathan Wei, “The advantage of Actemra is that it offers treating rheumatologists another weapon in our arsenal for treating rheumatoid arthritis. Nowadays, it is my expectation that when I see a patient with rheumatoid arthritis, I can count on getting them into remission. It may be only a short time into the future that we will be able to cure this disease.”

Roche, the manufacturer of Actemra in the United States, announced that the Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) by a near unanimous (10-1) vote recommended approval of Actemra (tocilizumab), a novel interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody, for reducing the signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA).

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Both George Harper & Nathan Wei 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.

George Harper has sinced written about articles on various topics from Arthritis Signs, Osteoporosis and Arthritis Signs. George Harper writes for where you can find out more about. George Harper's top article generates over 1600 views. to your Favourites.

Nathan Wei has sinced written about articles on various topics from Arthritis Pain, Health and Arthritis Signs. Nathan Wei, MD FACP FACR is a natioanlly known board-certified rheumatologist. For more info: an. Nathan Wei's top article generates over 550000 views. to your Favourites.