The curious case of rheumatoid arthritis
Published on: Thursday, February 12, 2015
Kuala Lumpur: Rheumatoid Arthritis (RA), which was once called a muscle wasting disease, affects 23.7 million people around the world. According to the World Health Organisation (WHO), 5 in 1,000 Malaysians struggle from the disease. As with other types of arthritis, RA affects the joint. The autoimmune disease causes joint inflammation and pain after joint tissues are attacked by the body's immune system. If left untreated, it can lead to deformity by permanently damaging parts of the joints such as cartilage, bones, tendons and ligaments.
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Though the cause of RA is not yet known, genetics has been identified as a factor in the genesis of the disease. It is said that a person may have an increased risk of acquiring RA if someone in their family has the disease. However, Sime Darby Medical Centre's Consultant Rheumatologist Dr Yeap Swan Sim said a vast majority of her RA patients had no family history of RA. "If you read general articles on RA they always say that there is a genetic predisposition to the disease, but actually it is not that common. "In reality, there is usually no warning that you are going to get RA, you will not know until you experience the joint pain and swelling," said Dr Yeap.
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Dr Yeap, who is also Malaysian Osteoporosis Society president, pointed out that statistically, women were three times more likely to suffer from the disease than men. "It's also interesting to note that among women who have RA, most will get better during their pregnancy. So there is a hormonal thing about it RA, but you can't say it without any concrete proof by research," she said, adding that smokers were the ones often affected by the disease.
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Though thousands of journals have been published and studies conducted on RA, its triggering factor is still a mystery to the medical fraternity. As a cure is not yet available, patients have to make do with pain management usually through the use of painkillers as well as stopping the inflammation. Dr Yeap stressed on the importance of recognising the symptoms of RA and undergoing early treatment before the joints were damaged. "It is key to get early diagnosis and early treatment. Unlike ten years ago, RA can now be detected at an early stage when the joints are not yet deformed and treatment can be done to preserve the joint's function," she said. Among the symptoms of RA that should not be neglected include persistent pain in the same joints on both sides of the body, swelling, as well as stiffness especially in the morning. "It is unlike the pain you get when you play badminton or other games, where it will fade away after three to four days. This pain is more persistent. Some may have pain every day for weeks or even months before they consult a doctor. "The joints may also look swollen and reddish. If you have these symptoms go and see a doctor. It might not necessarily be RA, but it could be another form of arthritis," warned Dr Yeap. She likened the arthritis process to a fire, which spreads inside the body, burning or painfully destroying joints and eventually bones. In order to curb these 'fires' or inflammation, disease-modifying antirheumatic drugs (DMARDs) are used to provide some relief. There are two types of DMARDs, namely the non-biologic and the biologic.The non-biologic works to generally suppress the immune system, whereas the biologic focuses on certain parts of the inflammatory pathway. "The biologic attacks specific molecules in the inflammatory pathway blocking certain processes from going on thus stopping the arthritis more effectively. However, taking these drugs increase the risk of infection," Dr Yeap explained. Quite recently, a new medicine called Xeljanz (tofacitinib citrate) was introduced. It is the first biologic medicine produced in tablet form. Xeljanz is considered a breakthrough in treating RA as previously patients received DMARDs by an injection. Stay up-to-date by following Daily Express’s Telegram channel.
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