202

Rheumatoid arthritis: Signs, symptoms and hope for those suffering

This content is sponsored by MedStar Washington Hospital Center

Rheumatoid arthritis is an autoimmune and inflammatory disease that primarily affects peripheral joints and causes inflammation and painful swelling. The Arthritis Foundation estimates about 1.5 million people in the United States have rheumatoid arthritis — yet new treatments being developed now can bring relief to those suffering and revolutionize patient care.

The most frequent rheumatoid arthritis symptoms include joint pain, stiffness, joint swelling, warmth and limited range of motion.

While joint pain is one of the common symptoms, rheumatoid arthritis can affect the whole body, said Dr. Konstantinos Loupasakis, a rheumatologist at MedStar Washington Hospital Center.

“It’s a systemic inflammatory disease, so it’s not just a disease of the joints — it can cause inflammation of the vital organs sometimes, and it can also affect the blood vessels and that’s why it’s recently been recognized as a factor for accelerated cardiovascular disease,” Dr. Loupasakis said.

Rheumatoid arthritis can look and feel different for different people depending on how severe their case is and for how long they’ve had it, he added. Rheumatoid arthritis typically affects women two to three times more frequently compared to men, and most people get the disease around their 50s, although it can happen earlier or later in life.

“What we know is there is a genetic predisposition, there is a genetic component to this disease so depending on the risk factors that the patients have in addition to that genetic predisposition, the manifestation of clinical disease can happen earlier or later in life,” Dr. Loupasakis said.

A doctor can diagnose rheumatoid arthritis following a thorough physical exam and specific laboratory workup. There is no single, specific test that can confirm a rheumatoid arthritis diagnosis, Dr. Loupasakis said, but there are tests that can lead to a diagnosis, including signs of inflammation, warmth, swelling and tenderness.

“All of these things together in the right age group can give us the clue that can lead to the diagnosis of that disease,” he said.

People with rheumatoid arthritis have a great chance at managing their symptoms, preventing further damage, and living relatively normal lives with current treatment options — especially if it’s treated early or before joints are heavily damaged.

“Things have really changed for the better in the recent years,” Dr. Loupasakis said. “Scientific breakthroughs have led to the development of really effective medications. And these medications have revolutionized the care of our patients.”

Patients’ only option used to be corticosteroids (“cortisone”), which worked quickly to cool flare ups and address pain and symptoms, but was unsafe as a long-term treatment because of side effects. But now there is a range of medications — tablets, injections and IV infusions — that can target the inflammation and often restore a patient’s functionality.

In the long term and if not aggressively treated, rheumatoid arthritis can cause damage to joints that can lead to permanent disability, especially when the joints get stiff and deformities develop, Dr. Loupasakis said. It’s rare that these outcomes happen today because of the availability of so many effective treatments, Dr. Loupasakis added.

“Patients diagnosed these days, they almost never progress to the extent that they would develop deformities in their joints,” he said.

Still it’s recommended that patients are treated promptly because rheumatoid arthritis can affect the whole body, including the heart and blood vessels. Treating it early can lessen its impact on a lot of other organs, he added.

Studies have found there are some risk factors associated with rheumatoid arthritis: smoking and poor oral hygiene. The risk factors are especially linked with those who have a genetic tie to rheumatoid arthritis. Both smoking and bad oral hygiene affect the tissues in the lungs and mouth in a way that may lead to stimulation of the immune system. As a result, inflammation can occur and may ultimately involve the joints, leading to rheumatoid arthritis.

It can be difficult for patients to stay positive as they take on an arduous, time-consuming process of finding the medication that works best for them, but Dr. Loupasakis recommends focusing on the best outcomes that can come out of it.

“These are chronic diseases, they have long lasting symptoms. It is understandable that a lot of patients can be very depressed because their life changes because of the pain and because of the loss of function,” he said. “So until we get them back in good shape … it is important to maintain a sense of optimism and support them emotionally and psychologically in order to go through that very unfortunate and unpleasant phase.”

The multidisciplinary approach at MedStar Washington Hospital Center is part of an effort to “provide the best care that we can based on the needs of our patients,” Dr. Loupasakis said.

“We are very up to date about the newest treatments,” Dr. Loupasakis said. “We want to be on the cutting edge of the treatments and the scientific progress that has been accomplished in our field.”

Read more about rheumatoid arthritis and listen to a podcast with Dr. Loupasakis here.