Rheumatoid Arthritis

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease where the immune system attacks the lining of joints (synovium), causing inflammation, pain, and eventually joint damage. It affects about 1% of the population and is more common in women.¹

Symptoms²

Joint Symptoms

• Pain, swelling, warmth in joints
• Symmetric involvement (both sides)
• Small joints often affected first (hands, feet)
• Morning stiffness >1 hour
• Joint deformity (if untreated)

Systemic Symptoms

• Fatigue
• Low-grade fever
• Loss of appetite
• Rheumatoid nodules

Diagnosis

• Clinical examination
• Blood tests: RF, anti-CCP antibodies, ESR, CRP
• Imaging: X-rays, ultrasound, MRI
• ACR/EULAR classification criteria

Treatment Goals

• Control inflammation
• Prevent joint damage
• Maintain function
• Achieve remission or low disease activity

Medications³

DMARDs (Disease-Modifying)

• Methotrexate - Cornerstone of treatment
• Sulfasalazine
• Hydroxychloroquine
• Leflunomide

Biologics

• TNF inhibitors (adalimumab, etanercept)
• IL-6 inhibitors (tocilizumab)
• B-cell depleting (rituximab)
• T-cell co-stimulation blockers (abatacept)

JAK Inhibitors

• Tofacitinib, baricitinib, upadacitinib

Lifestyle Management

• Regular exercise (low-impact)
• Joint protection techniques
• Balance rest and activity
• Anti-inflammatory diet
• Smoking cessation

References

1. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016;388(10055):2023-2038.
2. Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria. Arthritis Rheum. 2010;62(9):2569-2581.
3. Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016;68(1):1-26.