#RHEUMATOID_ARTHRITIS,
#रूमेटाइड_अर्थराइटिस होने के कारण, लक्षण और उपाय
RHEUMATOID ARTHRITIS
Rheumatoid arthritis is a long-term autoimmune disorder that primarily affects joints.
It typically results in warm, swollen, and painful joints.
RHEUMATOID ARTHRITIS CAUSES
Genetic susceptibility
An immunological reaction
Autoimmune responses
An inflammatory reaction in joints and tendon sheaths
The appearance of rheumatoid factors in the blood and synovium
Perpetuation of the inflammatory process
Articular cartilage destruction
RHEUMATOID ARTHRITIS EPIDEMIOLOGY
Affects 1-3% of the population world wide
With a peak prevalence between the ages of 30 and 50 years
Women are affected 3 or 4 times more commonly than men
SIGNS AND SYMPTOMS OF RHEUMATOID ARTHRITIS
Tender & Warm joints
Swollen joints
Fatigue
Fever
Loss of appetite
Joint stiffness that is usually worse in mornings & after inactivity
STAGES IN RHEUMATOID ARTHRITIS
STAGE 1 PRE-CLINICAL
STAGE 2 SYNOVIAL
STAGE 3 DESTRUCTION
STAGE 4 DEFORMITY
DIAGNOSIS OF RHEUMATOID ARTHRITIS
Primary Diagnosis based on the sign & symptoms
Mostly clinical features are observed in this
X-ray is performed for further detail diagnosis
Compare to normal in RA we can find bone erosion & displacement
DIAGNOSIS BASED ON X-RAY
HEMATOLOGICAL DIAGNOSIS IN RHEUMATOID ARTHRITIS
Full blood count (FBC) - normocytic hypochromic anaemia (due to abnormal erythropoiesis from chronic inflammation), WBC
Inflammatory markers- ESR, CRP elevated
(its use as indication of disease progression monitoring, treatment response)
Rheumatoid factor(RF)-anti-IgG auto Ab 80% will have it & Anti- cyclic citrullinated peptide (CCP) Ab
ROSE WAALER TEST FOR RHEUMATOID ARTHRITIS
WAALER-ROSE Bicolor is a haemagglutination slide test for the rapid qualitative and semi-quantitative detection of IgM Rheumatoid Factor in sera from most patients with c
MANAGEMENT & TREATMENT OF RHEUMATOID ARTHRITIS
There is no cure for rheumatoid arthritis
Aim to delay the progression (stages) of the disease, alleviate symptoms, reduce functional limitation
Supportive and palliative
MEDICATION AND MEDICINES FOR RHEUMATOID ARTHRITIS
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce inflammation, and bring down a high temperature.
They're often used to relieve symptoms of headaches, painful periods, sprains and strains, colds and flu, arthritis, and other causes of long-term pain.
Reduce inflammation and relieves pain
NSAIDs
Aspirin
Ibuprofen
Indomethacin
Naproxen
COX-2 inhibitors
Celecoxib
Valdecoxib
Analgesics medicines for rheumatoid arthritis
Analgesics are medicines that are used to relieve pain.
They are also known as painkillers or pain relievers.
Technically, the term analgesic refers to a medication that provides relief from pain without putting you to sleep or making you lose consciousness.
Analgesics & Painkillers.
In some cases, you may be advised to use painkillers, such as paracetamol or a combination of paracetamol and codeine or morphine to relieve the pain associated with rheumatoid arthritis.
These medicines do not treat the inflammation in your joints, but they may be helpful in relieving pain.
Glucocorticoids for rheumatoid arthritis
Corticosteroids are steroidal medications given to RA patients to reduce inflammation and help regulate autoimmune activity.
Corticosteroids have been used for over five decades to help treat RA symptoms.
Often times you will hear corticosteroids referred to as glucocorticoids
Corticosteroids are steroidal medications given to RA patients to reduce inflammation and help regulate autoimmune activity.
Corticosteroids have been used for over five decades to help treat RA symptoms.
Often times you will hear corticosteroids referred to as glucocorticoids
Prednisolone for rheumatoid arthritis
Patients who develop new rheumatoid arthritis are offered prednisolone either at a low dose of 7.5 mg daily
sometimes at a high dose (60mg daily) quickly reducing to the low dose over a few weeks, and then continue low dose treatment to control the joint destruction.
Slow joint damage caused by inflammation
Disease Modifying Antirheumatic Drugs
#DMARD
There are used with NSAIDs and/or prednisolone to slow joint destruction caused by RA over time.
Widely use to manage the condition of RA
Examples are
Methotrexate,
Injectable gold
Penicillamine
Azathioprine
Chloroquine,
Hydroxychloroquine,
Sulfasalazine
Oral gold
Biologic Response Modifiers and monoclonal antibodies
These drugs directly modify immune system by inhibiting proteins called cytokines, which contribute to inflammation
Examples
Abatacept
Etanercept
Infliximab
Adalimumab
Anakinra
Protein -A Immunoadsorption Therapy
Protein -A Immunoadsorption Therapy
This is not a drug, but a therapy that filters the blood to remove antibodies and immune complexes that promote inflammation
EXPERT LECTURE BY
MR AMAR M. RAVAL
FOUNDER PHARMAROCKS