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A Brief Note On Rheumatoid Arthritis ( Ra )

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Background: Rheumatoid Arthritis (RA) is a chronic autoimmune and inflammatory disease featuring progressive joint damage leading to functional impairment and disability (1). RA is classified as a progressive systemic disease due to the extra-articular manifestations involving the lungs and eyes but beginning and principally affecting the synovial joints (1). RA patients present with a wide array of joint functional impairment with persistent disease activity (1). RA affects approximately 0.8% of the general population with a peak onset between 40-70 years and affects females 3 times more than males (2). Additionally, due to the disabling nature of RA, it imposes a reduced and disabling quality of life whilst also posing a huge economic burden on the individual, the community and society (3).
The NICE guidelines provide a 3-step approach to manage RA: pharmacological, non-pharmacological and lastly, surgical treatment (3). The first line medication recommended by NICE is the disease-modifying anti-rheumatic drug (DMARDs), methotrexate (3). Though methotrexate (MTX) is effective in preventing progressive joint damage, it is ineffective in some patients, and even when effective, the consequent side effects and safety concerns contribute to poor patient adherence (4). More recently, biological-DMARDs have been used in place of the toxic methotrexate-like DMARDs. Biological-DMARDs target inflammation interleukins and chemokines; thereby interfering with the pathological

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