February 2 was Rheumatoid Arthritis Awareness Day. To commemorate this important occasion, we look at the information, science and technology surrounding the condition.

What is rheumatoid arthritis?

Rheumatoid Arthritis or RA is an autoimmune disorder. While normal arthritis is caused by the wearing down of joints, RA is caused by the body’s immune system attacking its own joints. Symptoms of RA include

• swelling
• pain
• stiffness
• redness
• unusual warmth
• loss of motor skills

Almost 3 times as many women get RA compared to men. While it usually occurs after age 30-40, children can also be affected. If you experience the symptoms, a doctor can perform x-rays and make a confirmed diagnosis.

RA can also cause anemia, and inflammation in the lungs, the membranes around the lungs (pleura) and heart (pericardium), and the whites of the eye.

What are current treatments for rheumatoid arthritis?

There is currently no cure for rheumatoid arthritis. Medication can be used to ease the symptoms, reduce inflammation, and slow down the progress of the disease. A treatment plan may involve combinations of the following

• steroids or NSAIDs/nonsteroidal anti-inflammatory drugs to relieve inflammation and pain
• DMARDs – disease modifying antirheumatic drugs that control the signs and symptoms of RA
• corticosteroids that block the immune system’s production of substances that trigger inflammation
• biologics/biopharmaceuticals which influence substances called cytokines in the body. Cytokines play a role in increasing or suppressing inflammation. However, biologics can be expensive and the body can build up a resistance to their effects or face extra immune damage from them.

Besides medication plans, people with rheumatoid arthritis can further benefit from

• exercise
• physical therapy
• occupational therapy
• nutrition and weight management

What are the current (assistive) technologies available to help?

Splints, orthotics, canes and crutches can help take stress off of joints and make movement easier. Reachers and chair leg extenders can help with hard-to-reach objects and ease the strain put on joints while sitting down or standing up.

Daily activities can be made easier with

• larger grips and handles
• grab bars for stability
• electric kitchen equipment, such as can openers, blenders and food processors
• bigger buttons or velcro fastening on clothing
• Ergonomic equipment, including stationery, home tools, cutlery and hygiene aids.

What does the future hold for people with RA?

Scientists are working on new combinations to treat RA with less medication and fewer side effects at a lower cost. A new drug compound called CDD-450/ATI-450 reduces inflammation, making it a possible treatment options for autoimmune disorders.

Future RA drug therapy could combine

• anti-tumour necrosis factor / anti-TNF drugs, which control a protein that affects inflammation in the body
• drugs that target molecules which regulate synovial fibroblasts, a type of cell in the joints which affects inflammation
• anti-angiogenic drugs, which stop new blood vessels from forming near joints and feeding inflammation.

Clinical trials on genetic profiling and gene therapy for rheumatoid arthritis are also currently underway. Genetic profiling can help doctors tailor a person’s course of medication for the best effects. Gene therapy may be able to lessen the effects of genes that cause the immune system to attack the body, or even shut them down completely.

Conclusion

Things are looking up for those with rheumatoid arthritis in the future, but it’s also important to support and uplift those living in the present. This chronic condition affects the joints and still has no cure. It’s up to Malaysians to understand the disease, the limitations it presents, and support RA research, advocacy and support programs.

References

Abbvie (2017) The Future of Rheumatoid Arthritis: How Genes, Lifestyle and Environment Factor In [Accessed: 8 Jan 2019] Available at: https://stories.abbvie.com/stories/the-future-rheumatoid-arthritis-how-genes-lifestyle-and-environment-factor-in.htm

Carol E. (2017) Facts About DMARDs (Disease-Modifying Anti-Rheumatic Drugs) [Accessed: 8 Jan 2019] Available at: https://www.verywellhealth.com/facts-about-dmards-188047

Diederik D.C. (2014) Rheumatoid Arthritis: New Effective and Cheaper Treatment [Accessed: 8 Jan 2019] Available at: https://www.disabled-world.com/health/autoimmunediseases/rheumatoid-arthritis/cobra.php

Disabled World (2011) Awareness Dates: Days – Weeks – Months [Accessed: 8 Jan 2019] Available at: https://www.disabled-world.com/disability/awareness/awareness-dates.php#feb

Disabled World (2017) Rheumatoid Arthritis: Diagnosis, Information and Treatment [Accessed: 8 Jan 2019] Available at: https://www.disabled-world.com/health/autoimmunediseases/rheumatoid-arthritis/

Malaysian Society of Rheumatology (2014) Inflammatory Arthritis and Biologic Therapy – Malaysian Consensus [Accessed: 8 Jan 2019] Available at: http://www.msr.my/file_dir/23463820354606bd842bdc.pdf

Marla P. (2018) Rheumatoid arthritis meets precision medicine [Accessed: 8 Jan 2019] Available at: https://www.sciencedaily.com/releases/2018/03/180319124232.htm

MIMS Malaysia (2019) Rheumatoid Arthritis [Accessed: 8 Jan 2019] Available at: https://specialty.mims.com/rheumatoid%20arthritis/treatment

Nancy R. (2006) Rheumatoid Arthritis Drugs [Accessed: 8 Jan 2019] Available at: https://web.archive.org/web/20061030172418/http://healthresources.caremark.com/topic/rheumarthdrugs

Verywell Health (2019) Assistive Devices for Arthritis [Accessed: 8 Jan 2019] Available at: https://www.verywellhealth.com/arthritis-assistive-devices-4013077

WebMD (2018) Assistive Devices for Easier Living With RA [Accessed: 8 Jan 2019] Available at: https://www.webmd.com/rheumatoid-arthritis/guide/assistive-devices#1

WebMD (2018) Biologics for Treating Rheumatoid Arthritis [Accessed: 8 Jan 2019] Available at: http://www.webmd.com/solutions/treatments-rheumatoid-arthritis/promising-advances