There are over two million people in the US with Rheumatoid Arthritis (RA). Those who suffer with it experience pain and inflammation in their joints, accompanied by swelling, stiffness, fever and fatigue. If left untreated, it can progress to total dysfunction of the joints. Relief does appear to be close at hand, with a new generation of treatments being trialed today.



The disease affects most people from middle age, but some children and young adults can face earlier onset (Juvenile Arthritis). Unlike Ankylosing Spondylitis, it affects double or more women than men. Rheumatoid arthritis usually affects both sides of the body, which is called having symmetrical symptoms. This means if a person has it in one knee, they will have it in the other as well. It commonly affects the wrists and finger joints, but can be in any part of the body.

Some symptoms that aren't in the joints are anemia, a decrease in the production of red blood cells, muscular neck pain and dry eyes and mouth and, in some rare cases, inflamed blood vessels and lining of the lungs or heart. Some people will have shorter flair ups of RA that last a month or two, while others can have longer periods with severe symptoms for years on end.

The longer Rheumatoid Arthritis is actively causing symptoms, it is also causing more irreparable damage and disability to its victims. Osteoporosis is more prominent in long-term sufferers, which often means their bones will fracture very easily. Muscles that are used to support the joints are either weakened or suffer from over-use, causing referred pain and disability. As Rheumatoid Arthritis starts causing its damage very early on, rapid diagnosis is becoming prominently important.

Rheumatoid Arthritis is a disease that affects the immune system, causing the body to turn against itself and attack healthy joint tissue. No specific cause has been identified, but it is believed that genetics, environment, hormones and stress levels can all have an impact. It is diagnosed with a combination of a physical examination of the joints, reflexes, muscle stability and appearance of the skin, a blood test for white blood cell count and an x-ray that will show up any long-term joint damage.

Some patients may require surgery. This would not be a first option for most people and is usually joint replacement or tendon reconstruction surgery. Otherwise, treatment focuses on the right medication, regular rest, regular, appropriate exercise, healthy eating, increased awareness and psychological support. The aim is to take away the pain, eliminate swelling, discontinue or disable tissue destruction, maintain flexibility and minimize fatigue and stress factors.

In the past, the only treatments available for Rheumatoid Arthritis were aspirin, paracetamol and anti-inflammatory drugs that often contain steroids. Specialists would wait until the disease progressed to more advanced stages before prescribing anything more powerful. As it is now known that the damage is started much earlier on in its course, stronger treatments and combinations are recommended to try to halt the progression and, hopefully, avoid disability later in life.

One powerful form of treatment is the Non-steroidal Anti- inflammatory Drugs (NSAIDs), which reduce pain and decrease inflammation. They can cause side effects such as an upset stomach, peptic ulcers, excessive bleeding and renal failure and a patient cannot drink any alcohol due to the extra strain they can place on the liver. Some examples are Ibuprofen, Ketoprofen and Naproxen. These are also used to treat Ankylosing Spondylitis, Juvenile Arthritis and Psoriasis.

Disease-modifying anti-rheumatic drugs (DMARDs) are also a common treatment and are known to reduce pain in swollen joints and retard joint damage. They can take between a few weeks or a few months to work and there are also side effects to consider. Taking DMARDs can heighten the infection risk, cause loss of hair and possibly cause damage to the liver or kidneys. Methotrexate is a well-known DMARD and is administered orally or injected. It has been found especially effective when combined with the new generation treatment, ENBREL. There have been countless medicines produced over the years in hope of helping those with Rheumatoid Arthritis, Ankylosing Spondylitis, Juvenile Arthritis and Psoriasis, but it is these new drugs that appear to possibly be on the track to providing relief.

Biologic response modifiers are the current Rheumatic Arthritis drugs that have been showing great promise for patients. Clinical trials that have been underway have produced data which suggests they reduce inflammation and slow the progression of the disease and the damage it causes. ENBREL (aka etanercept) works by stopping the over production of the body's cytokines, which is the protein the immune system has been using to kill the healthy joint tissue. It is usually administered with a fortnightly injection.

The drug is a Tumor Necrosis Factor Inhibitor. RA sufferers are known to have too much TNFa being produced (as do those with Ankylosing Spondylitis, Juvenile Arthritis and Psoriasis) and when ENBREL and TNFa blocker protein reduces the cytokine levels, patients feel remarkable improvements. The main side effect of taking ENBREL is a weakening of the immune system, so infections could potentially be fatal. It is for this reason doctors have to apply very strict screening for trail admissions, as anyone with an already compromised immunity can not possibly take it. ENBREL's more minor side effects could be a sore, burning in the throat and/or a rash where the needle entered and/or a blocked, runny nose. Otherwise it is proving itself to possibly be the new revolutionary treatment to stop the progression of the disease.

Over the past twenty years or so, a large amount of research has been done on Rheumatoid Arthritis. Through experts increased awareness of how the immune system works and the role of genetics and human biology, RA treatments are being viewed with new and excited eyes. Scientists are finding that combinations of treatments are better than one alone, such as ENBREL and methotrexate, which can noticeably slow damage to joints. The aim for all involved in the search for the answer is to continue helping victims by relieving their pain, reducing inflammation and swelling, slow or stop damage to joints and restore their ability to function every day. This can be achieved with ongoing monitoring of medication, lifestyle and side effect management. If the need for surgery can be avoided or delayed, this is definitely a step in the right direction.

Disclaimer: The information above should not be interpreted as medical advice. Please talk to a qualified professional for more information about Rheumatoid Arthritis.