This document provides an overview of rheumatoid arthritis (RA), including its definition, pathophysiology, clinical presentation, risk factors, diagnosis, treatment options, and complications. RA is a chronic inflammatory disorder that commonly affects the joints, causing pain, swelling, stiffness and loss of mobility. Treatment involves both pharmacological and non-pharmacological approaches, with disease-modifying antirheumatic drugs (DMARDs) like methotrexate as first-line options. If DMARDs are ineffective, biological DMARDs may be used. Managing risk factors and treating complications can help improve outcomes for those living with RA.
This document provides an overview of the management of rheumatoid arthritis (RA). It discusses the etiology and pathology of RA and describes the diagnostic criteria. It then outlines various treatment approaches for RA including physical therapies, medications like NSAIDs, glucocorticoids, DMARDs, and biologics. Newer targeted biologic therapies that inhibit cytokines like TNF-α, IL-1, IL-6 are discussed. The goals of RA treatment and factors influencing treatment choice are also summarized.
Rheumatoid arthritis and osteoarthritis are common forms of arthritis. Rheumatoid arthritis is a systemic inflammatory disease that affects the joints and other organs, causing progressive joint deformity if not treated early. It can be a potentially fatal illness with increased risks of infections, renal impairment and cardiovascular disease. Osteoarthritis is the most common joint disorder and affects older individuals, particularly the weight-bearing joints like the hips and knees. It involves the breakdown of cartilage and bone within a joint. Management of both conditions involves conservative measures as well as medications aimed at reducing pain and inflammation.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints and surrounding tissues. It can affect multiple organs and is considered a systemic illness. The cause is unknown but is believed to involve genetic susceptibility and environmental triggers activating an immune response. Treatment involves medications to reduce inflammation and slow joint damage, physical therapy, exercise and lifestyle changes, and sometimes surgery. The goals are to relieve pain, reduce inflammation, prevent further joint damage, and improve quality of life.
Rheumatoid arthritis current diagnosis and treatmentAnkur Varshney
This document provides information on the diagnosis and management of rheumatoid arthritis (RA). It begins with an introduction to RA, noting that it is a chronic inflammatory joint disease affecting approximately 1% of the population. It then discusses the clinical presentation and manifestations of RA, including onset, patterns of joint involvement, and articular and extra-articular symptoms. The document reviews the diagnostic criteria for RA and covers laboratory investigations and radiographic features. It concludes with an overview of the goals and various treatment modalities for RA, including NSAIDs, corticosteroids, disease-modifying antirheumatic drugs (DMARDs), immunosuppressive therapies, and biological therapies.
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder of unknown etiology characterized by polyarticular symmetric joint involvement and systemic manifestations.
Rheumatoid arthritis is a chronic inflammatory disease that causes pain, stiffness, and swelling in the joints. It occurs when the immune system mistakenly attacks the joints, causing the synovial membrane to become inflamed. Over time, this can cause cartilage and bone damage and limit function. Treatment focuses on reducing inflammation, managing symptoms, and preventing further joint damage through medications, surgery, and lifestyle changes. While there is no cure, proper treatment can help improve quality of life by reducing pain and disability.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation and damage to joints. It affects around 1-3% of the global population. While its exact causes are unknown, genetic and environmental factors are believed to play a role. Key symptoms include tender, warm, swollen joints and morning stiffness lasting over an hour. Diagnosis is based on criteria such as the number and location of affected joints, presence of rheumatoid factor or anti-CCP antibodies, and response to treatment. Treatment aims to control symptoms, prevent further joint damage, and improve quality of life using medications such as methotrexate, sulfasalazine, biologics that target cytokines, and newer drugs like tofacitinib. The
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints and causes pain, swelling, stiffness and loss of function. It affects around 1% of the population worldwide. Recent advances in management include earlier diagnosis using classification criteria from ACR/EULAR and aggressive treatment with disease-modifying antirheumatic drugs alone or in combination with biological therapies that target cytokines like TNF-α. While DMARDs can control symptoms, biological therapies may induce remission and prevent further joint damage by acting faster than conventional treatments. Prompt diagnosis and management can now improve long-term outcomes for those suffering from rheumatoid arthritis.
This document provides an overview of the management of rheumatoid arthritis (RA). It discusses the etiology and pathology of RA and describes the diagnostic criteria. It then outlines various treatment approaches for RA including physical therapies, medications like NSAIDs, glucocorticoids, DMARDs, and biologics. Newer targeted biologic therapies that inhibit cytokines like TNF-α, IL-1, IL-6 are discussed. The goals of RA treatment and factors influencing treatment choice are also summarized.
Rheumatoid arthritis and osteoarthritis are common forms of arthritis. Rheumatoid arthritis is a systemic inflammatory disease that affects the joints and other organs, causing progressive joint deformity if not treated early. It can be a potentially fatal illness with increased risks of infections, renal impairment and cardiovascular disease. Osteoarthritis is the most common joint disorder and affects older individuals, particularly the weight-bearing joints like the hips and knees. It involves the breakdown of cartilage and bone within a joint. Management of both conditions involves conservative measures as well as medications aimed at reducing pain and inflammation.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints and surrounding tissues. It can affect multiple organs and is considered a systemic illness. The cause is unknown but is believed to involve genetic susceptibility and environmental triggers activating an immune response. Treatment involves medications to reduce inflammation and slow joint damage, physical therapy, exercise and lifestyle changes, and sometimes surgery. The goals are to relieve pain, reduce inflammation, prevent further joint damage, and improve quality of life.
Rheumatoid arthritis current diagnosis and treatmentAnkur Varshney
This document provides information on the diagnosis and management of rheumatoid arthritis (RA). It begins with an introduction to RA, noting that it is a chronic inflammatory joint disease affecting approximately 1% of the population. It then discusses the clinical presentation and manifestations of RA, including onset, patterns of joint involvement, and articular and extra-articular symptoms. The document reviews the diagnostic criteria for RA and covers laboratory investigations and radiographic features. It concludes with an overview of the goals and various treatment modalities for RA, including NSAIDs, corticosteroids, disease-modifying antirheumatic drugs (DMARDs), immunosuppressive therapies, and biological therapies.
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder of unknown etiology characterized by polyarticular symmetric joint involvement and systemic manifestations.
Rheumatoid arthritis is a chronic inflammatory disease that causes pain, stiffness, and swelling in the joints. It occurs when the immune system mistakenly attacks the joints, causing the synovial membrane to become inflamed. Over time, this can cause cartilage and bone damage and limit function. Treatment focuses on reducing inflammation, managing symptoms, and preventing further joint damage through medications, surgery, and lifestyle changes. While there is no cure, proper treatment can help improve quality of life by reducing pain and disability.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation and damage to joints. It affects around 1-3% of the global population. While its exact causes are unknown, genetic and environmental factors are believed to play a role. Key symptoms include tender, warm, swollen joints and morning stiffness lasting over an hour. Diagnosis is based on criteria such as the number and location of affected joints, presence of rheumatoid factor or anti-CCP antibodies, and response to treatment. Treatment aims to control symptoms, prevent further joint damage, and improve quality of life using medications such as methotrexate, sulfasalazine, biologics that target cytokines, and newer drugs like tofacitinib. The
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints and causes pain, swelling, stiffness and loss of function. It affects around 1% of the population worldwide. Recent advances in management include earlier diagnosis using classification criteria from ACR/EULAR and aggressive treatment with disease-modifying antirheumatic drugs alone or in combination with biological therapies that target cytokines like TNF-α. While DMARDs can control symptoms, biological therapies may induce remission and prevent further joint damage by acting faster than conventional treatments. Prompt diagnosis and management can now improve long-term outcomes for those suffering from rheumatoid arthritis.
Rheumatoid arthritis is a chronic inflammatory disease that commonly results in joint damage and physical disability. It is characterized by a symmetric, peripheral polyarthritis of unknown etiology that most frequently involves the small joints of the hands and feet. While the disease primarily affects the joints, it can also result in a variety of systemic manifestations involving other organ systems. The risk of rheumatoid arthritis is genetically influenced and increases with certain HLA-DRB1 alleles.
Rheumatoid arthritis (RA) is a progressive inflammatory disorder characterized by symmetric synovitis and joint erosions. Approximately 1% of adults are affected. RA results in significant costs, morbidity, and mortality. The pathogenesis involves genetic and immunological factors. Early diagnosis and treatment can slow structural damage. Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate are first-line treatments, with the goal of controlling disease activity and slowing progression. Combination DMARD therapy may provide superior outcomes to single agents. New therapies are still needed to further improve safety profiles and disease control.
Rheumatoid arthritis(RA) is the most common type of autoimmune arthritis. It is triggered by a faulty immune system(the body’s defence system) and affects the wrist and small joints of the hand, including the knuckles and the middle joints of the fingers.
Treatments have improved greatly and help many of those affected. For most people with RA, early treatment can control join pain and swelling, and lessen joint damage.
Perform low-impact aerobic exercises such as walking, and exercises to boost muscle strength. This will improve your overall health and reduce pressure on your joints.
People who receive early treatment are more likely to feel better sooner and lead an active life. They are also less likely to have the type of joint damage that leads to joint replacement.
Expertise is vital to make an early diagnosis of RA and to rule out diseases that mimic RA. Rheumatologists are experts in RA and can design a customized treatment plan that is best for you.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It affects around 1-2% of the population, most often women. Treatment involves controlling inflammation to slow disease progression and manage symptoms. This is achieved through a combination of pharmacological and non-pharmacological therapies including NSAIDs, corticosteroids, DMARDs, biologics, exercise, and assistive devices. The goal of treatment is reduced joint tenderness, swelling and pain as well as improved quality of life. Careful monitoring is required due to potential adverse effects of long-term drug therapy.
Rheumatoid arthritis is an autoimmune disease that causes inflammation, swelling, and pain in the joints. It affects approximately 1% of the world's population and 0.92% of the adult population in India. There are two main types - seropositive RA, where the body produces immune reactions to normal tissue, and seronegative RA, where tests for rheumatoid factor and anti-CCP antibodies are negative. Risk factors include age 40-60, family history, smoking, obesity, and female sex. Diagnosis involves evaluating symptoms, x-rays of affected joints, and blood tests for rheumatoid factor and anti-CCP antibodies. Treatment includes non-pharmacological therapies as well as drugs like
The document provides an overview of advancements in the treatment of rheumatoid arthritis. It discusses the disease characteristics and course, classification criteria, treatment objectives and guidelines, and various therapies including biologics. A case example is presented of a patient with joint pains and symptoms meeting classification criteria for rheumatoid arthritis.
Rheumatoid arthritis is an autoimmune disease that causes inflammation of the joints, resulting in pain, swelling, stiffness and destruction of cartilage and bone. It most commonly affects small joints in the hands and feet. Conventional treatments include NSAIDs, disease-modifying anti-rheumatic drugs like methotrexate, and corticosteroids. However, these may have side effects or lose effectiveness over time. Biological therapies targeting cytokines like TNF-α have significantly improved treatment outcomes, with anti-TNF agents infliximab, etanercept and adalimumab being widely used options.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints and causes pain, stiffness, and swelling. It impacts around 1% of the adult population worldwide. While conventional disease-modifying antirheumatic drugs (DMARDs) like methotrexate are usually the first line of treatment, biological DMARDs or biologics targeting molecules like tumor necrosis factor (TNF) are used for cases that are resistant to conventional DMARDs. Biologics have revolutionized RA treatment by providing rapid relief and preventing long-term joint damage. The monoclonal antibody rituximab depletes B cells and is effective for RA by reducing inflammation and rheumatoid factor levels. It is administered as two 1000 mg intravenous
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the synovial joints, resulting in pain, stiffness, and swelling. It affects around 1% of the population worldwide. The cause is unknown but is believed to involve genetic and environmental factors. Diagnosis is based on symptoms, blood tests for rheumatoid factor and CRP levels, and x-ray evidence of joint damage. Treatment aims to reduce inflammation and prevent further joint destruction, using medications like NSAIDs, DMARDs, corticosteroids, and biologics. Surgery may be required in advanced cases to repair damaged joints.
Rheumatoid arthritis clinical overview and tips for managementdrdeeptichawla
Rheumatoid arthritis is a chronic inflammatory autoimmune disorder that mainly affects the small joints, resulting in pain, stiffness, and loss of function. It has no known cure and conventional treatments can have adverse effects. Homoeopathy offers a natural approach by regulating the immune system using carefully selected individualized remedies without side effects. Some common homoeopathic medicines used to manage rheumatoid arthritis symptoms include Berberis vulgaris for rheumatic pains that change location, Bryonia alba for aggravated pain with movement and stiffness, and Rhus tox for pain and stiffness relieved by motion.
This document provides information on rheumatoid arthritis (RA) including its pathophysiology, epidemiology, clinical features, and treatment with disease-modifying antirheumatic drugs (DMARDs). RA is a chronic inflammatory disease that causes peripheral polyarthritis. Treatment involves non-biological DMARDs like methotrexate and sulfasalazine as well as biological DMARDs that target cytokines like TNF-α. Biological agents have improved treatment outcomes for RA by reducing joint damage and disability.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It affects around 1-3% of the population and is more common in women. Symptoms include joint stiffness, pain, swelling, and loss of function. Left untreated, it can cause permanent joint damage and disability. Treatment involves medications to reduce inflammation and prevent joint damage, including NSAIDs, steroids, DMARDs such as methotrexate, and biologic medications that target specific immune system proteins. The goals of treatment are to relieve symptoms, prevent disability, and induce remission if possible through a combination of medications, physical therapy, education, and lifestyle changes.
Chronic symmetrical polyarthritis is characterized by chronic joint pain, stiffness, and swelling. It is associated with inflammation of the synovium of peripheral joints. The disease course involves exacerbations and remissions. It predominantly affects women between ages 20-40. Causes include genetic factors and autoimmunity. Advanced stages involve destruction of articular cartilage and bone erosion, leading to deformities such as finger spindling and foot deformities. Diagnosis is based on clinical features and meeting criteria for rheumatoid arthritis including joint swelling and morning stiffness. Management involves pharmacological treatments like NSAIDs and DMARDs as well as surgery.
Rheumatoid arthritis is an autoimmune disease where the body's immune system attacks the joints, causing chronic inflammation. It most commonly affects the small joints in hands and feet, though any joint can be involved. Symptoms include swollen, painful, and stiff joints. While medications can help manage symptoms and slow disease progression, there is no cure. Treatment involves medications like NSAIDs, DMARDs such as methotrexate, biologics that target TNF, steroids, and lifestyle changes including exercise and diet. The goal of treatment is to reduce inflammation and prevent further joint damage.
Rheumatoid arthritis is an autoimmune disease that results in chronic systemic inflammation that can affect many tissues, but principally attacks synovial joints. It affects 1-3% of adults and is more common in females. Diagnosis is based on meeting 4 out of 7 criteria including morning stiffness, joint pain/swelling in specific joints, rheumatoid nodules, positive rheumatoid factor or imaging findings. If left untreated it can cause joint deformity, erosion and damage. Treatment involves medications like NSAIDs, DMARDs, steroids and surgery in some cases. Juvenile rheumatoid arthritis is the same condition but in children under 16 years of age.
Rheumatoid arthritis is diagnosed based on a patient's history, physical examination, and diagnostic tests rather than a single test. Early diagnosis and treatment are important to slow disease progression and prevent structural joint damage. Treatment involves non-pharmacological measures as well as a variety of drug therapies including NSAIDs, DMARDs such as methotrexate, and biologic DMARDs, with the goal of relieving pain, reducing inflammation, and maintaining function. Ongoing monitoring of disease activity is needed to assess treatment effectiveness.
Rheumatoid arthritis is an autoimmune disease characterized by inflammation of the joints, especially in the hands and feet. It affects around 1% of the population and is more common in women. If left untreated, chronic inflammation can lead to joint damage and disability. Management involves reducing inflammation and pain with medications like NSAIDs, corticosteroids, and disease-modifying antirheumatic drugs (DMARDs), with the goal of achieving remission and preventing long-term joint damage and deformity.
The system you must inquire more about for this patient is the gastrointestinal system. Her presentation of fatigue, dizziness, anorexia and pale appearance suggests potential blood loss, likely from NSAID-induced peptic ulcer disease given her risk factors of long-term NSAID use and past history of peptic ulcer. A thorough GI exam and labs are warranted to evaluate for potential bleeding.
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder of unknown etiology characterized by polyarticular symmetric joint involvement and systemic manifestations.
1. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that targets the synovial tissue, with a prevalence of 0.8% in adults worldwide.
2. Current therapeutic approaches for rheumatoid arthritis focus on early, aggressive intervention and include medications such as DMARDs, biologics, corticosteroids, and surgery.
3. DMARDs are first-line medications and include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Biologics that target cytokines like TNF-alpha and IL-6 are used if DMARDs are ineffective or for severe disease.
Rheumatoid arthritis is a chronic inflammatory disease that commonly results in joint damage and physical disability. It is characterized by a symmetric, peripheral polyarthritis of unknown etiology that most frequently involves the small joints of the hands and feet. While the disease primarily affects the joints, it can also result in a variety of systemic manifestations involving other organ systems. The risk of rheumatoid arthritis is genetically influenced and increases with certain HLA-DRB1 alleles.
Rheumatoid arthritis (RA) is a progressive inflammatory disorder characterized by symmetric synovitis and joint erosions. Approximately 1% of adults are affected. RA results in significant costs, morbidity, and mortality. The pathogenesis involves genetic and immunological factors. Early diagnosis and treatment can slow structural damage. Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate are first-line treatments, with the goal of controlling disease activity and slowing progression. Combination DMARD therapy may provide superior outcomes to single agents. New therapies are still needed to further improve safety profiles and disease control.
Rheumatoid arthritis(RA) is the most common type of autoimmune arthritis. It is triggered by a faulty immune system(the body’s defence system) and affects the wrist and small joints of the hand, including the knuckles and the middle joints of the fingers.
Treatments have improved greatly and help many of those affected. For most people with RA, early treatment can control join pain and swelling, and lessen joint damage.
Perform low-impact aerobic exercises such as walking, and exercises to boost muscle strength. This will improve your overall health and reduce pressure on your joints.
People who receive early treatment are more likely to feel better sooner and lead an active life. They are also less likely to have the type of joint damage that leads to joint replacement.
Expertise is vital to make an early diagnosis of RA and to rule out diseases that mimic RA. Rheumatologists are experts in RA and can design a customized treatment plan that is best for you.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It affects around 1-2% of the population, most often women. Treatment involves controlling inflammation to slow disease progression and manage symptoms. This is achieved through a combination of pharmacological and non-pharmacological therapies including NSAIDs, corticosteroids, DMARDs, biologics, exercise, and assistive devices. The goal of treatment is reduced joint tenderness, swelling and pain as well as improved quality of life. Careful monitoring is required due to potential adverse effects of long-term drug therapy.
Rheumatoid arthritis is an autoimmune disease that causes inflammation, swelling, and pain in the joints. It affects approximately 1% of the world's population and 0.92% of the adult population in India. There are two main types - seropositive RA, where the body produces immune reactions to normal tissue, and seronegative RA, where tests for rheumatoid factor and anti-CCP antibodies are negative. Risk factors include age 40-60, family history, smoking, obesity, and female sex. Diagnosis involves evaluating symptoms, x-rays of affected joints, and blood tests for rheumatoid factor and anti-CCP antibodies. Treatment includes non-pharmacological therapies as well as drugs like
The document provides an overview of advancements in the treatment of rheumatoid arthritis. It discusses the disease characteristics and course, classification criteria, treatment objectives and guidelines, and various therapies including biologics. A case example is presented of a patient with joint pains and symptoms meeting classification criteria for rheumatoid arthritis.
Rheumatoid arthritis is an autoimmune disease that causes inflammation of the joints, resulting in pain, swelling, stiffness and destruction of cartilage and bone. It most commonly affects small joints in the hands and feet. Conventional treatments include NSAIDs, disease-modifying anti-rheumatic drugs like methotrexate, and corticosteroids. However, these may have side effects or lose effectiveness over time. Biological therapies targeting cytokines like TNF-α have significantly improved treatment outcomes, with anti-TNF agents infliximab, etanercept and adalimumab being widely used options.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints and causes pain, stiffness, and swelling. It impacts around 1% of the adult population worldwide. While conventional disease-modifying antirheumatic drugs (DMARDs) like methotrexate are usually the first line of treatment, biological DMARDs or biologics targeting molecules like tumor necrosis factor (TNF) are used for cases that are resistant to conventional DMARDs. Biologics have revolutionized RA treatment by providing rapid relief and preventing long-term joint damage. The monoclonal antibody rituximab depletes B cells and is effective for RA by reducing inflammation and rheumatoid factor levels. It is administered as two 1000 mg intravenous
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the synovial joints, resulting in pain, stiffness, and swelling. It affects around 1% of the population worldwide. The cause is unknown but is believed to involve genetic and environmental factors. Diagnosis is based on symptoms, blood tests for rheumatoid factor and CRP levels, and x-ray evidence of joint damage. Treatment aims to reduce inflammation and prevent further joint destruction, using medications like NSAIDs, DMARDs, corticosteroids, and biologics. Surgery may be required in advanced cases to repair damaged joints.
Rheumatoid arthritis clinical overview and tips for managementdrdeeptichawla
Rheumatoid arthritis is a chronic inflammatory autoimmune disorder that mainly affects the small joints, resulting in pain, stiffness, and loss of function. It has no known cure and conventional treatments can have adverse effects. Homoeopathy offers a natural approach by regulating the immune system using carefully selected individualized remedies without side effects. Some common homoeopathic medicines used to manage rheumatoid arthritis symptoms include Berberis vulgaris for rheumatic pains that change location, Bryonia alba for aggravated pain with movement and stiffness, and Rhus tox for pain and stiffness relieved by motion.
This document provides information on rheumatoid arthritis (RA) including its pathophysiology, epidemiology, clinical features, and treatment with disease-modifying antirheumatic drugs (DMARDs). RA is a chronic inflammatory disease that causes peripheral polyarthritis. Treatment involves non-biological DMARDs like methotrexate and sulfasalazine as well as biological DMARDs that target cytokines like TNF-α. Biological agents have improved treatment outcomes for RA by reducing joint damage and disability.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It affects around 1-3% of the population and is more common in women. Symptoms include joint stiffness, pain, swelling, and loss of function. Left untreated, it can cause permanent joint damage and disability. Treatment involves medications to reduce inflammation and prevent joint damage, including NSAIDs, steroids, DMARDs such as methotrexate, and biologic medications that target specific immune system proteins. The goals of treatment are to relieve symptoms, prevent disability, and induce remission if possible through a combination of medications, physical therapy, education, and lifestyle changes.
Chronic symmetrical polyarthritis is characterized by chronic joint pain, stiffness, and swelling. It is associated with inflammation of the synovium of peripheral joints. The disease course involves exacerbations and remissions. It predominantly affects women between ages 20-40. Causes include genetic factors and autoimmunity. Advanced stages involve destruction of articular cartilage and bone erosion, leading to deformities such as finger spindling and foot deformities. Diagnosis is based on clinical features and meeting criteria for rheumatoid arthritis including joint swelling and morning stiffness. Management involves pharmacological treatments like NSAIDs and DMARDs as well as surgery.
Rheumatoid arthritis is an autoimmune disease where the body's immune system attacks the joints, causing chronic inflammation. It most commonly affects the small joints in hands and feet, though any joint can be involved. Symptoms include swollen, painful, and stiff joints. While medications can help manage symptoms and slow disease progression, there is no cure. Treatment involves medications like NSAIDs, DMARDs such as methotrexate, biologics that target TNF, steroids, and lifestyle changes including exercise and diet. The goal of treatment is to reduce inflammation and prevent further joint damage.
Rheumatoid arthritis is an autoimmune disease that results in chronic systemic inflammation that can affect many tissues, but principally attacks synovial joints. It affects 1-3% of adults and is more common in females. Diagnosis is based on meeting 4 out of 7 criteria including morning stiffness, joint pain/swelling in specific joints, rheumatoid nodules, positive rheumatoid factor or imaging findings. If left untreated it can cause joint deformity, erosion and damage. Treatment involves medications like NSAIDs, DMARDs, steroids and surgery in some cases. Juvenile rheumatoid arthritis is the same condition but in children under 16 years of age.
Rheumatoid arthritis is diagnosed based on a patient's history, physical examination, and diagnostic tests rather than a single test. Early diagnosis and treatment are important to slow disease progression and prevent structural joint damage. Treatment involves non-pharmacological measures as well as a variety of drug therapies including NSAIDs, DMARDs such as methotrexate, and biologic DMARDs, with the goal of relieving pain, reducing inflammation, and maintaining function. Ongoing monitoring of disease activity is needed to assess treatment effectiveness.
Rheumatoid arthritis is an autoimmune disease characterized by inflammation of the joints, especially in the hands and feet. It affects around 1% of the population and is more common in women. If left untreated, chronic inflammation can lead to joint damage and disability. Management involves reducing inflammation and pain with medications like NSAIDs, corticosteroids, and disease-modifying antirheumatic drugs (DMARDs), with the goal of achieving remission and preventing long-term joint damage and deformity.
The system you must inquire more about for this patient is the gastrointestinal system. Her presentation of fatigue, dizziness, anorexia and pale appearance suggests potential blood loss, likely from NSAID-induced peptic ulcer disease given her risk factors of long-term NSAID use and past history of peptic ulcer. A thorough GI exam and labs are warranted to evaluate for potential bleeding.
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder of unknown etiology characterized by polyarticular symmetric joint involvement and systemic manifestations.
1. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that targets the synovial tissue, with a prevalence of 0.8% in adults worldwide.
2. Current therapeutic approaches for rheumatoid arthritis focus on early, aggressive intervention and include medications such as DMARDs, biologics, corticosteroids, and surgery.
3. DMARDs are first-line medications and include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Biologics that target cytokines like TNF-alpha and IL-6 are used if DMARDs are ineffective or for severe disease.
Rheumatoid arthritis is a chronic inflammatory disease characterized by inflammation of the synovial lining of joints which can lead to cartilage and bone destruction. Key symptoms include joint pain, stiffness, swelling and fatigue. The disease is caused by an immune system attack on the joints that results in inflammation mediated by cytokines like TNF-alpha and IL-6. Treatment involves non-pharmacologic measures as well as disease-modifying drugs like methotrexate, hydroxychloroquine and biologics that target cytokines to reduce inflammation and slow disease progression.
The document discusses the management of rheumatoid arthritis, including the pharmacist's role. It provides an outline and covers the epidemiology, etiology, signs and symptoms, pathophysiology, risk factors, diagnosis, and pharmacological and non-pharmacological management. It also presents a case study of a 33-year-old female patient diagnosed with rheumatoid arthritis and summarizes her medical history, examinations, lab results, and treatment plan. The pharmacist's responsibilities in counseling patients and ensuring appropriate drug therapy are also outlined.
This document provides information on various rheumatological conditions including osteoarthritis, gout, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, Sjogren's syndrome, and polymyalgia rheumatica. It describes the diagnostic criteria, clinical features, organ involvement, treatment recommendations, and important complications for each condition. Key points include the importance of Heberden's and Bouchard's nodes in diagnosing osteoarthritis, using allopurinol to treat gout and prevent attacks, methotrexate and TNF inhibitors for treating rheumatoid arthritis, and aggressive treatment of lupus nephritis to prevent morbidity.
Rheumatoid arthritis is a chronic inflammatory autoimmune disease that primarily affects the joints, causing pain, stiffness, and swelling. It is characterized by inflammation of the synovium of joints resulting from an abnormal immune response. Common symptoms include symmetric polyarthritis of small joints in hands and feet. Treatment involves use of NSAIDs, steroids, and disease-modifying antirheumatic drugs (DMARDs) like methotrexate, hydroxychloroquine, and sulfasalazine to reduce joint damage and preserve function.
This document provides information about rheumatoid arthritis (RA). It discusses the following key points:
1. RA is a progressive autoimmune disorder characterized by symmetric inflammation of the joints and potential damage to cartilage and bone. It most commonly affects women between ages 35-60.
2. Symptoms include pain, swelling, and stiffness in the small joints of the hands and feet. Left untreated, it can lead to joint deformities and loss of function.
3. Treatment involves relieving pain, reducing inflammation, and slowing disease progression through medications like DMARDs, biologics, steroids, and NSAIDs. Early, aggressive treatment is important to control symptoms and prevent long-term damage.
This document discusses rheumatoid arthritis (RA), including its diagnosis, management, and treatment. Some key points:
1) RA is a common inflammatory joint disease that affects approximately 1% of the population. It is characterized by persistent inflammatory synovitis leading to joint damage.
2) Diagnosis is based on symptoms like morning stiffness and joint involvement patterns, along with serological markers like rheumatoid factor and anti-CCP antibodies. Disease activity is monitored through clinical exams, labs, and imaging.
3) Treatment involves a multidisciplinary approach including medications like NSAIDs, DMARDs such as methotrexate, steroids, and biologics that target cytokines like TNF-α to reduce
This document discusses rheumatoid arthritis and gout. It provides information on the pathogenesis, clinical presentation, diagnosis and management of these conditions. It lists various disease-modifying antirheumatic drugs and biological agents used to treat rheumatoid arthritis, along with their mechanisms of action, dosing and side effects. It also discusses the evaluation and treatment of acute and chronic gout, including use of colchicine, NSAIDs, allopurinol and febuxostat.
This document discusses resistant and relapsing polymyositis. It begins by defining resistant disease as when a patient does not respond to adequate doses of steroids plus another immunosuppressant for at least three months. It then discusses several treatment options for resistant disease, including rituximab, intravenous immunoglobulin, tacrolimus, and others. It also describes four scenarios for relapsing polymyositis and the recommended approaches for each scenario.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation in the joints. It can lead to pain, swelling, and joint damage over time. The document discusses the pathophysiology and symptoms of RA and provides details on the various classes of medications used to treat RA, including analgesics, anti-inflammatory drugs, biologic agents, corticosteroids, and disease-modifying antirheumatic drugs. It also lists many of the specific medications in each class.
Rheumatoid arthritis is a chronic inflammatory disease that primarily involves the joints, including the hands, wrists, and knees. It causes pain, stiffness, swelling of the joints, and can lead to joint deformity and loss of physical function if left untreated. While its cause is unknown, it affects around 0.3-1.5% of the population, with higher prevalence in women. Treatment involves medication such as DMARDs and glucocorticoids to reduce inflammation and prevent further joint damage, as well as exercise and assistive devices.
Juvenile rheumatoid arthritis (JRA) is a general term for arthritis in children. It is characterized by joint inflammation, swelling, and pain. There are different subtypes classified by the number and pattern of involved joints. Treatment has shifted to more aggressive early treatment with medications to prevent long-term joint damage, and may include NSAIDs, disease-modifying antirheumatic drugs like methotrexate, biologic medications, and corticosteroids depending on the subtype and severity of symptoms. JRA can cause long-term disabilities but early treatment aims to improve prognosis and prevent complications.
Juvenile rheumatoid arthritis (JRA) is a general term for arthritis and related conditions occurring in children under 16 years old. It is characterized by inflammation of connective tissues causing joint swelling and pain. There are different subtypes classified based on the number and pattern of involved joints. Treatment has shifted to more aggressive early treatment with medications to prevent joint damage, and includes NSAIDs, DMARDs like methotrexate, biologics like etanercept, and corticosteroids. Outcomes depend on subtype, but can include long term joint damage, disability, and risk of continued arthritis into adulthood.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the joints and can damage bone and cartilage. It progresses through four stages, from initial attack of joint tissue by the immune system to potential fusing of joints. Symptoms include joint swelling, stiffness, and tenderness. Diagnosis involves blood tests to check for rheumatoid factor and C-reactive protein levels. Treatment aims to reduce inflammation and prevent further joint damage through lifestyle changes, medications like disease-modifying antirheumatic drugs and biologics, and sometimes surgery.
Methotrexate is an anti-metabolite drug used to treat psoriasis and rheumatoid arthritis. It works by inhibiting dihydrofolate reductase and interfering with DNA synthesis. It was first approved by the FDA in 1971 for psoriasis. Methotrexate is absorbed quickly after oral administration and distributed throughout the body, with potential side effects including hepatotoxicity, bone marrow suppression, and pulmonary toxicity. Careful monitoring of liver and blood tests is required when using this drug.
This document provides information on the treatment of rheumatoid arthritis (RA) including disease-modifying anti-rheumatic drugs (DMARDs). It discusses the case of a 58-year-old lady with a 3-year history of RA who is experiencing a flare up. Her treatment options include starting DMARD monotherapy or combination therapy depending on her disease activity level to prevent further joint destruction while also using steroids for symptomatic relief. DMARDs like methotrexate work by modifying the immune system to slow disease progression and should be started early for best outcomes.
Rheumatoid arthritis Part 1 Basics & guideline application on real life cases...Ahmed Yehia
Rheumatoid arthritis Part 1 Basics & guideline application on real life cases Ahmed Yehia Ismaeel, Beni-Suef University
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2. DEFINITION
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder
of unknown etiology characterized by polyarticular symmetric joint
involvement and systemic manifestations.
6. CLINICAL PRESENTATION:
EARLY FEATURE:
Most commonly affects MCPJ and PIPJ, wrist, tendon sheaths around the
joints (wrist – feet – knee – shoulder )
Bilateral symmetrical polysynovitis
Pain, fusiform swelling, stiffness, loss of mobility
Constitutional symptom:
- malaise, low-grade fever
- tenosynovitis
7. LATE FEATURE (DESTRUCTIVE)
Spread to other joint
Morning stiffness(more than 30mins) – improve with activity
MORE LATER (DEFORMITY)
Pain, deformity, instability, decreased ROM
Thumb – Z-deformity
Fingers – swan neck deformity, boutonniere’s deformities, ulnar deviation
Wrist – radial and volar displacement
Elbow – limited extension
Shoulder – limited abduction
Knees – swollen
Toes – clawed
8.
9. RISK FACTORS
Factors that may increase your risk of rheumatoid arthritis include:
Gender . Women are more likely than men to develop rheumatoid arthritis.
Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle
age.
Family history. If a member of your family has rheumatoid arthritis, you may have an
increased risk of the disease.
Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis,
particularly if you have a genetic predisposition for developing the disease. Smoking
also appears to be associated with greater disease severity.
Environmental exposures. Although poorly understood, some exposures such as
asbestos or silica may increase the risk of developing rheumatoid arthritis.
Obesity. People — especially women age 55 and younger — who are overweight or
obese appear to be at a higher risk of developing rheumatoid arthritis.
11. DIAGNOSIS
Laboratory tests
Rheumatoid factor (RF) detectable in
60% to 70%.
Anticyclic citrullinated peptide (anti-
CCP) antibodies have similar sensitivity
to RF but are more specific and are
present earlier in the disease.
Elevated erythrocyte sedimentation rate
and C-reactive protein are markers for
inflammation.
Normocytic normochromic anaemia is
common as is thrombocytosis.
Other diagnostic tests
Joint fluid aspiration may show
increased white blood cell counts
without infection, crystals.
Joint radiographs may show
periarticular osteoporosis, joint space
narrowing, or erosions.
18. Management:
Before start of therapy:
CBC
Serum creatinine – should be normal
LFT – SGOT, SGPT should be normal
Viral markers
Chest x ray – ask history of TB
Rheumatoid factor
ESR/CRP
After start of therapy:
Monitor CBC, serum creatinine, LFT, ESR every 3 months
19. DMARDS
should be started within the first 3 months of symptom onset
DMARDs commonly used include methotrexate, hydroxychloroquine,
sulfasalazine, and leflunomide.
Methotrexate is first line agent
20. DRUG OF CHOICE FOR RA
METHOTREXATE
DOSE: 7.5mg/week – 25mg/week
Start with 10mg/week
MTX shows response after 6-12 weeks
Patient needs to report after 2-4 weeks with LFT
If patient has tolerated the dose then increase dose @5mg/week up to 25mg/week
FORM OF THERAPY:
Below 15mg/wk. – oral
Above 15mg/wk. – SC/IM
Intrathecal for single joint involvement – usually given in cancer
HOW LONG TO GIVE THE THERAPY?
3-5 yrs. minimum duration of therapy
Patients with response to MTX cures with more frequency
21. MOA:
Methotrexate inhibits cytokine production, inhibits purine biosynthesis,
and may stimulate release of adenosine, all of which may lead to its anti
inflammatory properties.
ADR OF MTX: GI (stomatitis, nausea/vomiting, diarrhoea),
myelosuppression (thrombocytopenia, leukopenia), hepatic (elevated
enzymes, rarely cirrhosis), pulmonary (fibrosis, pneumonitis), rash
Contraindications:
chronic liver disease
Immunodeficiency
pleural or peritoneal effusions
leukopenia, thrombocytopenia, preexisting blood disorders
creatinine clearance of less than 40 mL/min.
22. LEFLUNOMIDE
Used as Alternative to MTX
Leflunomide is a DMARD that inhibits pyrimidine synthesis, leading to a decrease in
lymphocyte proliferation and modulation of inflammation.
Leflunomide has efficacy similar to methotrexate for treating rheumatoid arthritis.
DOSE: loading dose – 100mg daily for 3 days
maintenance dose – 20mg daily
Lower doses - if patients have gastrointestinal intolerance, complain of hair loss, or have
other signs of dose-related toxicity.
contraindicated in patients with preexisting liver disease.
The drug is teratogenic,
Because leflunomide undergoes enterohepatic circulation, the drug takes many months to
drop to a plasma concentration considered safe during pregnancy. Hence should be given to
patients who are above 40yrs.
Cholestyramine may be used to rapidly clear the drug from plasma
23. HYDROXYCHLOROQUINE
The main advantage of hydroxychloroquine is the lack of
myelosuppressive, hepatic, and renal toxicities that may be seen with other
DMARDs, which simplifies monitoring
Dose: Oral: 200–300 mg bid, after 1–2 months may ↓ to 200 mg bid or
daily
OTHER DMARDS:
Sulfasalazine, Gold salts, azathioprine, D-penicillamine, cyclosporine,
cyclophosphamide, and minocycline have all been used to treat
rheumatoid arthritis.
24. BIOLOGICAL DMARDS - BIOLOGICS
Effective for patients who fail treatment with other DMARDs.
25. IMPORTANT POINTS REGARDING
BIOLOGICS
Given when response to DMARD’s
alone is poor
Biologics always given in combination
with MTX in RA
Increase the risk of infections
Screen for latent TB and hepatitis B
before therapy
There should be no infections before,
while or after starting the therapy
Patient should be asked to report
slightest infection
Vaccinate for influenza
If patient already has an infection, treat
the infection before starting therapy
Tuberculin skin testing is recommended
prior to treatment with these drugs.
If patient develop infections while on
biologic agents temporarily discontinue
them until the infection is cured.
Given for a short course of 3-9 months
High cost
26. INFLIXIMAB
DOSE: IV infusion of 3 mg/kg at 0, 2, and 6 weeks and then every 8 weeks.
Infliximab should be given in combination with methotrexate to prevent
development of antibodies that may reduce drug efficacy or induce
allergic reactions.
combination of methotrexate plus infliximab halted progression of joint
damage in patients and was superior to methotrexate monotherapy
27. CORTICOSTEROIDS
They are valuable in controlling symptoms before the onset of action of
DMARDs.
This is referred to as a “bridge therapy”
A burst of corticosteroids can be used in acute flares.
Continuous low doses may be adjuncts when DMARDs do not provide
adequate disease control.
may be injected into joints and soft tissues to control local inflammation
Prednisone is the most often used steroid in RA treatment.
ADR: Hypertension, hyperglycaemia, osteoporosis
28. USE OF STEROIDS IN RA
Lowest dose – prednisone ≤ 7.5mg/day
Lowest duration - ≤ 3 months
Used as initial therapy with MTX
INTRAMUSCULAR ROUTE: preferred in patients with compliance problems.
Ex: triamcinolone acetonide, triamcinolone hexacetonide, and methylprednisolone
acetate.
provides the patient with 2 to 6 weeks of symptomatic control.
INTRAARTICULAR STEROIDS: preferred due to lesser side effects
Given if small number of joints are affected
one joint should not be injected more than 2-3 times /year because of the risk of
accelerated joint destruction and atrophy of tendons..
Daily supplements of calcium (800–1,000 mg) and vitamin D (400–800 units) are
recommended along with steroids.
29. NSAIDS
Adjuncts to DMARD treatment.
Reduce stiffness and pain associated with rheumatoid arthritis.
Few examples of NSAIDS:
Aspirin 2.6–5.2 g ---Four times daily
Celecoxib 200–400 mg — Daily to twice daily
Diclofenac 150–200 mg — Three times per day to four times daily
ADR: GI ulceration and bleeding, renal damage
Aspirin - contraindicated in children
30. COMBINATION THERAPY
Given when there is active disease even when MTX is ≥15mg/wk. for 8-12
weeks
TRIPLE THERAPY:
MTX+ sulfasalazine(1-2g/day)- start with 500mg/day +
hydroxychloroquine(200-400mg/day)
Given to patients who didn’t respond to MTX alone
OR
Leflunomide (100mg daily for 3 days then 10-20mg daily)+ sulfasalazine +
hydroxychloroquine
Methotrexate + sulfasalazine +prednisone
infliximab + methotrexate
31. JUVENILE IDIOPATHIC ARTHRITIS
Clinical presentation:
The morning stiffness and joint pain may manifest as increased irritability, guarding of involved
joints, or refusal to walk. Fatigue, low-grade fever, anorexia, weight loss, failure to grow
Treatment:
NSAID:
NSAID therapy is the treatment of choice for treating the joint manifestations as well as the febrile
episodes in systemic-onset JIA
Ex: Naproxen 10 to 15 mg/kg/day (maximum, 750 mg) in two daily divided doses
DMARD:
For patients with polyarticular disease MTX is given 5 to 15 mg/m2 (0.15–0.5 mg/kg) orally or
subcutaneously each week
BIOLOGIC DMARD:
Etanercept (Enbrel), the only FDA-approved biological agent for the treatment of JIA
Indicated for patients 4 years of age and older whose conditions have failed to respond to one or
more DMARDs
Dose : 0.4 mg/kg (maximum, 25 mg) subcutaneously twice weekly.
32. ANEMIA IN RA
RA can cause anemia of chronic disease
If MTX is given, give folic acid to manage anemia
If MTX is causing Hb drop >1-2g/dl – discontinue MTX
HEPATITIS IN RA:
Hydroxychloroquine+ sulfasalazine
Do not give biologics
RENAL DYSFUNCTION:
If sr. creatinine is >30ml/min low dose MTX is given
If sr. creatinine is <30ml/min, sulfasalazine+ low dose hydroxychloroquine
34. VITAMIN SUPPLEMENTS
Folic acid - Because MTX is a folic acid antagonist, it can induce a folic acid
deficiency. This deficiency is thought to be partly responsible for methotrexate
toxicity, and supplementation with folic acid does alleviate some adverse effects.
Dose: 5mg weekly/5mg daily other than the day of MTX administration
Vitamin D- given as weekly therapy for 8-10 weeks, then given as monthly therapy
Calcium- initially 1g/day, later 500mg/day
Vitamin B12
35. MANAGEMENT OF RA DURING
PREGNANCY
BEFORE PREGNANCY:
Discontinue MTX at least 3 months before pregnancy - teratogenic
If pregnancy is confirmed – discontinue MTX
Controlled disease for at least 6 months
Avoid MTX, leflunomide and biologics during pregnancy
DURING PREGNANCY:
1st trimester – hydroxychloroquine ±sulfasalazine
2nd trimester – hydroxychloroquine + sulfasalazine
3rd trimester – hydroxychloroquine + steroids SOS
POST DELIVERY:
Hydroxychloroquine
36. COMPLICATIONS OF RA
Rheumatoid arthritis increases your risk of developing:
Osteoporosis. Rheumatoid arthritis itself, along with some medications used for treating
rheumatoid arthritis, can increase your risk of osteoporosis — a condition that weakens your
bones and makes them more prone to fracture.
Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points,
such as the elbows. However, these nodules can form anywhere in the body, including the lungs.
Sjogren's syndrome People who have rheumatoid arthritis are much more likely to experience
Sjogren's syndrome, a disorder that decreases the amount of moisture in your eyes and mouth.
Felty’s Syndrome: Rheumatoid arthritis in association with splenomegaly and neutropenia is
known as Felty’s syndrome. Thrombocytopenia also may be a manifestation of the syndrome
Abnormal body composition. The proportion of fat to lean mass is often higher in people who
have rheumatoid arthritis, even in people who have a normal body mass index (BMI)..
37. Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the
inflammation can compress the nerve that serves most of your hand and
fingers.
Heart problems. Rheumatoid arthritis can increase your risk of hardened
and blocked arteries, as well as inflammation of the sac that encloses
heart(pericarditis)
Lung disease. People with rheumatoid arthritis have an increased risk of
inflammation and scarring of the lung tissues, which can lead to
progressive shortness of breath.
Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group
of blood cancers that develop in the lymph system
38. How to differentiate between RA and
Ankylosing spondylitis
Rheumatoid arthritis
Most common in females (35-50yrs)
Pain in knuckles, hands, small joints –
deformity occurs if therapy is not
given
CSR, CRP elevated
Positive rheumatoid factor
Positive anti citrullinated antibody
Ankylosing spondylitis
Young males(20-40yrs)
Patient complaints of backache in the
morning
Sacro- ileac joint inflammation
Buttock pain
Bamboo spine
Pain at rest – goes away on exercising
HLA B27 positive