It’s Rheumatoid Arthritis Awareness Week

This week (18 – 24 June 2018) marks Rheumatoid Arthritis awareness week, and was launched in an effort to educate the public about this debilitating disease (if left untreated) and the impact it has on those suffering from the disease, significantly effecting their daily quality of life.

Rheumatoid Arthritis (RA) is a chronic inflammatory disease effecting predominantly the small joints of the hands, as well as larger joints, in a symmetrical pattern. It can also cause a number of extra-articular manifestations, and can affect the heart, lungs, kidneys, peripheral nervous system and skin.

It occurs more commonly in women, especially during their reproductive years (age 20 -50) but can also present later in life.

Worldwide, the incidence of RA is around 1 % of the population, however there is regional variation, with some ethnic groups e.g. native American Indians up to 5 % of the population being effected.

The cause of RA is a complex interplay between the environment, genetics and the immune system.

Up to 30% of susceptible individuals have a unique chromosomal sequence, termed the “shared epitope” that predisposes them to the development of RA.

Smoking is the single most important environmental risk factor implicated in the development of RA, with smokers having a higher risk of developing RA and is also associated with more severe disease as well as increased likelihood of developing extra -articular manifestations of the disease.

The environmental triggers in a genetically susceptible patient results in the activation of the immune system with subsequent development of auto-antibodies, namely Rheumatoid Factor (RF) and Anti-citrullinated Cyclic Peptide (ACPA), that form immune complexes and accumulate in the joints, causing local destruction of the cartilage and bone surface, and inflammation of the joint lining (synovium) resulting in arthritis.

Typically, patients present with early morning stiffness lasting more than thirty minutes, and improve gradually during the day with activity. They will also have symmetrical joint involvement i.e. arthritis effecting predominantly both hands and wrists, and invariably the larger joints too.

Left untreated, RA can cause significant morbidity, severely impacting the patient and their family’s quality of life. Once there is established joint disease, the patients develop severe deformities of the hands and feet, effecting their ability to perform activities of self-care and daily living, often requiring assistance.

Treatment is with a combination of immuno-suppressant drugs, anti-inflammatories and adjunctive therapies e.g. assistive devices like hand splints. Treatment instituted early enough, will avoid any permanent damage to the joints, however it requires lifelong therapy, as currently there is no cure for RA.

In summary, although RA can be a debilitating disease, there is hope for those suffering from the disease, with new drug therapies and treatment modalities on the market. Remission is definitely an achievable goal.

For more information or to book a consultation please contact:

Dr Debbie Haasbroek

MBBch(Wits), FCP (SA), Rheum (Cert)

Specialist Physician, Rheumatologist

Suite B23, Life Fourways Hospital

Telephone: 011 875 1830