Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and damage throughout the body, typically affecting both sides symmetrically. The main symptoms are joint pain, swelling, stiffness, and fatigue. Risk factors include family history, smoking, obesity, and certain infections. Left untreated, RA can lead to complications affecting the skin, eyes, blood, lungs, heart, and increase risk of infections. Diagnosis involves physical exams of joints and blood tests like rheumatoid factor. Treatment includes non-pharmacological therapies as well as disease-modifying drugs, NSAIDs, biological agents, and corticosteroids.

1. RHEUMATOID
ARTHRITIS
Dr. Ajith JS
Asst. Professor
Department of Pharmacology
Sanjivani College of Pharmaceutical Education & Research, Kopargaon

2. INTRODUCTION
▹ Rheumatoid arthritis (RA) is an autoimmune disease that can cause
joint pain and damage throughout the body
▹ The joint damage that RA causes usually happens on both sides of
the body

3. PATHOPHYSOLOGY
Triggering
factors
( MHC, STAT)
Increase
inflammatory
mediators
Release B-
cells
T- cell
activation
Auto immune
T-cell
Proliferation
of T cell

4. SYMPTOMS
The main symptoms of rheumatoid arthritis are:
▹ Joint pain
▹ Joint swelling, warmth and redness
▹ Stiffness, especially first thing in the morning or after sitting still for a long time.
Other symptoms can include:
▹ Tiredness and lack of energy – this can be known as fatigue
▹ Weight loss
▹ A high temperature, or a fever
▹ Sweating
▹ Dry eyes – as a result of inflammation
▹ Chest pain – as a result of inflammation.
▹

5. RISK FACTORS
Exposure to certain types of bacteria
Having a history of viral infections
Smoking cigarettes
▹ Sex
▹ Having a family history of RA
▹
▹
▹
▹ Having obesity

6. COMPLICATIONS
 Effects on the Skin
 Eye Complications
 Pain in the Neck
 Heart and Blood Vessel Disease
 Blood Disease
 Lung Problems
 Infections

7. DIGNOSIS
Physical examination
Examining joint function and range of motion
Touching the affected joints to check for warmth and tenderness
▹ Looking for swelling and redness
▹
▹
▹ Testing your reflexes and muscle strength

8. Blood test
▹ Rheumatoid factor test
▹ Anticitrullinated protein antibody test
▹ Anti nuclear antibody test
▹ Erythrocyte sedimentation rate
▹ C-reactive protein test.
 DAS 28

9. Nonpharmacological treatment
▹ Physiotherapy
▹ Physical activity
▹ Hydrotherapy
▹ Foot care
TREATMENT
6)NICE guideline Draft for consultation, January 2018Rheumatoid arthritis in adults: management [Internet], cited on 22 Aug 2020; Available from;
https://www.nice.org.uk/guidance/ng100/documents/draft-guideline
7)Daniel Aletaha, Tuhina Neogi, Alan J. Silman,2010 Rheumatoid Arthritis diagnosis Criteria An American College of Rheumatology/European League Against Rheumatism [Internet], cited
on 22 Aug 2020;Available from; https://www.rheumatology.org/Portals/0/Files/2010_revised_diagnostic criteria ra.pdf
8)JASVINDER A. SINGH, KENNETH G. SAAG 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis[Internet], cited on 22 Aug 2020;Available
from; https://www.rheumatology.org/Portals/0/Files/ACR%202015%20RA%20Guideline.
9)Aneela Mian , Fowzia Ibrahim and David L. Scott A systematic review of guidelines for managing rheumatoid arthritis [Internet], cited on 22 Aug 2020;Available from;
https://bmcrheumatol.biomedcentral.com/track/pdf/10.1186/s41927-019-0090-7

10. Pharmacological treatment
▹ First-line treatment for RA was disease-modifying anti-rheumatic drug (DMARD)
Eg, T. Methotrexate 7.5 mg once a week
T. Leflonumide 10 mg OD ( second line DMARD)
▹ NSAIDs
Eg, T. Ibuprofen 200mg TID
T. Naproxen 250mg BD
▹ Biological agents
Eg, Inj .Tocilizumab 4mg/kg IV once in a month and 162mg SC once in a
week
Inj .Infliximab 3mg/kg IV once in every 2 weeks
▹ Corticosteroids
Eg,T. Prednisolone 5- 60 mgOD