Prevalence of Rheumatoid Arthritis Worldwide, the prevalence of RA is believed to be between 0.4 and 1.3 percent of the population. The incidence of rheumatoid arthritis in the United States is a little lower than the international average. In 2005, 1.5 million Americans—about 0.6 percent of the population were diagnosed with RA. In the United States, between 1995 and 2007, 41 people out of 100,000 were diagnosed with the condition. While RA can develop in the younger years, the likelihood of developing rheumatoid arthritis increases with age. The chances of being diagnosed with this disorder increase after 40, peak at 74 years of age, and then decline. What is Rheumatoid Arthritis? Rheumatoid arthritis (RA) is an autoimmune disorder of the joints that can lead to chronic pain and permanent disability if not treated properly. In rheumatoid arthritis, the patient’s own body basically attacks itself via the components of the immune system known as antibodies. Everyone has antibodies, which are designed to ward off infection and evict anything that is foreign to the body. In the RA patient, however, these antibodies mistake healthy tissues of the joint for enemies and attack those cells leading to a breakdown of the joint integrity.

Symptoms of Rheumatoid Arthritis The first sign of rheumatoid arthritis is generally going to be pain and inflammation in the smaller joints such as those in the fingers and toes. As the disease progresses, pain and inflammation spread to larger joints, including wrists, ankles, knees, shoulders, etc. Further progression of the disease involves erosion of the tissues at the joints, and this can lead to short-term or long-term deformity or loss of mobility. This deformity is more likely to present in hands and feet and can cause a deviation of the finger mimicking a swan neck in shape. In its more advanced state, rheumatoid arthritis often causes a condition known as rheumatoid nodules. These are cyst-like lumps of tissue that typically accumulate around pressure points like elbows. However, they can occur in any part of the body and have been known to compromise the patient’s lungs. Rheumatoid arthritis can lead to a number of other health issues including dry mouth and dry eyes, increased body fat in people who are not overeating, and carpal tunnel syndrome. The most serious complications of RA are hardening and blocking of arteries leading to and from the heart, leading to heart disease; scarring and inflammation of lungs; lymphoma; and liver damage.

Rheumatoid arthritis is somewhat of a medical mystery. Doctors believe that genetics influence the development of the disorder, but environmental factors, i.e. habits and activities within the patient’s control, may determine whether someone at risk does or does not develop RA. Genetic First, let us look at the genetic component of RA. People with rheumatoid arthritis have been found to have antibodies in their systems called anti-citrullinated protein/peptide antibodies (ACPAs for short). These antibodies, which attack the patient’s own proteins, signal the presence of RA. ACPAs are the most reliable predictor of RA. Another genetic marker of RA risk is the “rheumatoid factor.” The rheumatoid factor is also an antibody that shows up in patient blood work, but it is present in only eighty percent of actual rheumatoid arthritis patients. Both the rheumatoid factor and ACPAs can be accurately assessed with a blood test. Family History Anyone with a close family member who has developed rheumatoid arthritis should assume that he or she is at risk unless a blood test has clearly shown the absence of ACPAs and the rheumatoid factor. However, it is important to note that not everyone with ACPAs will develop rheumatoid arthritis. Age Age and gender play an important role.

In treating rheumatoid arthritis, the aim is to reduce pain, retain the maximum mobility, and slow the progress of the disease. At the same time, those who treat RA patients must bear in mind that medications used in the treatment of this disorder often cause serious health problems by themselves. Risks must be carefully and precisely weighed against benefits. Patients should, in particular, take the minimum medication needed to control pain and inflammation, taking care, not to overdose. Medications To slow down the progress of rheumatoid arthritis, doctors prescribe disease-modifying antirheumatic drugs (DMARDS). There are two classes of such drugs. First generation DMARDS are hydroxychloroquine, sulfasalazine, methotrexate, and leflunomide. Newer drugs, called “biologic agents,” include abatacept, adalimumab, anakinra, certolizumab, etanercept, and several others. A typical treatment regime will pair a biologic agent with one of the first generation DMARDS. Non-steroidal anti-inflammatory drugs (NSAIDS) are the preferred medications for day-to-day pain management. Many of these drugs are available without a prescription. The Mayo Clinic recommends ibuprofen (available as Advil and Motrin) and naproxen sodium (available as Aleve) in the daily treatment of pain association with RA. Patients who take ibuprofen on a daily basis must be monitored for signs of kidney, liver, and heart failure.