Rheumatoid Arthritis(RA) is the most common type of autoimmune arthritis. RA is a progressive and debilitating musculoskeletal disorder that affects the joints symmetrically, causing a range of systemic effects. What it causes is still not well known; nevertheless, findings of new research points towards a believe that it is triggered by a defective immune system, which causes the release of inflammatory chemicals. These chemicals cause damage to cartilage and bone, usually affecting the wrists, the joints of the hand, including the knuckles, the middle joints of the fingers and feet. While this condition can affect any joints, besides, important body organs such as the eyes and the lungs can also be affected by the inflammation that occurs as a result of this chronic condition. Only in America 1.3 million of people are affected by this ailment, and 75 % of them are mainly women. Its onset usually occurs between fourth and sixth decades; however, RA can occur at any age("Diseases And
In order to establish a treatment, plan it is important to set goals for this patient. In general goals for RA include early recognition and diagnosis, referral to a rheumatologist, and tight control and low disease activity (Cohen & Cannella, 2017). There are also scales that need to be completed by the NP and patient to determine how the treatment is working for a patient. When setting goals, it is important to determine a successful way to evaluate this patients' pain. In the older population it is common for pain to be under treated and part of the cause of this is because the assessment for pain is not matching the patients' needs. Once a successful evaluation has been chosen for this pain it would be important to use this same
Rheumatoid Arthritis has been subject of numerous studies and researches in the look for a better understanding of how it effects the individuals diagnosed with it. There is a higher incident of females diagnosed with RA than male as well as a relationship with genetic and environmental factors involved. Around one percent of the world population is affected by RA; therefore, diverse studies have been performed to understand how the lives of the diagnosed patients can be impacted by the disease. For example, how RA affects the mobility, safety and activities of daily living in general as well as the development of interventions to better approach RA. On
The type of treatment chosen depends on the type of arthritis and the effects it has on the patient as well as the severity of the disease. Other factors to consider are the age of the patient and the joints affected. Bearing in mind that different people exhibit different reactions to different medications, treatment in this case is individualized but includes a combination of joint protection methods and medication. For rheumatoid arthritis, the Initial treatment starts with non steroidal ant inflammatory drugs and other simple analgesic but as the inflammation progresses, slow acting anti rheumatoid drugs which are aimed at modifying the disease are introduced. They are added progressively as the inflammation progresses in order to suppress the process that leads to chronic inflammation (Amin 1995).
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
These types of disorders are sometimes treated by using TNF inhibitor. This inhibition is usually done with a monoclonal antibody such as Infliximab, an anti-TNF drug. Infliximab is used to treat rheumatoid arthritis by administering infliximab intravenously, in 6-8 week intervals (The British Pharmacology Society, 2011). Infliximab works by preventing TNF - alpha from binding to its receptors in the cell, as a result inhibiting TNF - alpha from carrying out functions in the immune response. Rheumatoid arthritis, is a disease associated with chronic joint inflammation, severe pain, stiffness, and swelling. Rheumatoid arthritis occurs when the body mistakenly attacks itself, in most cases inflammation is supposed to occur when the body is fighting off an invasion however with this disease, it occurs when the immune system malfunctions and starts to attack itself (Health Union,
20 patients with active RA in 1992 were first to be treated with infliximab. There was a dramatic drop in C-reactive protein (CRP and ethrocyte sedimentation rate. However patients relaped with 3-8 week demonstrating that they require another dose of
One review (7) researches studies conducted on Disease-modifying antirheumatic drugs (DMARDs), a medication commonly used in patients suffering from rheumatoid arthritis. DMARDs work to prevent or reduce joint damage, decrease pain and inflammation, and to preserve the structure and function of joints in the body (8). Other anti-inflammatory drugs or pain relieving medications, such as ibuprofen or naproxen, are often given to provide a faster relief of symptoms caused by rheumatoid arthritis (8). However, DMARDs are commonly used in combination with these pain relievers as a way to prevent damage to joints (8). The most common DMARD that is used to treat rheumatoid arthritis is methotrexate (9). It has been proven that early therapeutic intervention using methotrexate not only improves clinical outcome, but reduces the amount of joint damage and disability as well (9). The typical dose of Methotrexate is around 10-25 mg per week (10). Methotrexate can be taken orally or as an injection. However I would
In one study, a randomized trial was conducted in which half of a group of arthritis patients were given 200 mg of Celebrex daily and half were given 1,200 mg of SAM-e joint health supplements daily over the course of 16 weeks. The study found that the Celebrex group showed far more pain reduction during the first month than the SAM-e group, but by the second month, both groups showed an equal and significant lessening of pain. The research concluded that although slower-acting, SAM-e joint health supplements are just as effective as Celebrex for osteoarthritis-related knee
In time, I discovered a constantly evolving field, one having made recent advances in biologic agents, thus opening up limitless opportunities for research. Moreover in managing side effects of immunosuppressants/biologic agents that are the mainstay of therapy in rheumatology produced its own set of challenges. These were but a few reasons why rheumatology held me
Rheumatoid arthritis is characterized by excessive inflammation, particularly in the joints leading to irreversible damage (Contreras-Yáñez, Ponce De León, Cabiedes, Rull-Gabayet, and Pascual-Ramos, 2010). Pain and joint damage leads to limited mobility, decreased function and a reduced quality of life (Elliot, 2008). TNF blockers provide significant improvement in patient outcomes “by reducing pain,
A critique of an article published by The New York Times suggests a Breakthrough in treatment for joint pain of patients suffering from Rheumatoid arthritis. The article suggests that a drug known as a Biologic taken with Methotrexate may effectively treat pain and swelling symptoms caused by Rheumatoid Arthritis. Before critiquing the article, it is necessary to discuss the anatomy and physiology of Rheumatoid Arthritis so you may have a better understanding of the disease and the possible treatments. Rheumatoid Arthritis is classified as an autoimmune disease; it is a chronic inflammatory disorder in which the immune system attacks the tissues of the synovial joints of the individual who is suffering from the disease (Marieb and Hoehn 2013). The attacks cause inflammation to the synovial joints; the onset of inflammation brings both pain and swelling to the joint (Marieb and Hoehn 2013). Inflammatory cells appear in the joint cavity of the synovial joint and release inflammatory chemicals that destroy the body tissue at the joint (Marieb and Hoehn 2013). The disease is bilateral, meaning that if it affects a joint on one side of the body, for example the left wrist; chances are that it will affect the same joint on the opposite side of the body (Marieb and Hoehn 2013).
The consensus recommendation of the expert panel is that “treatment of people with arthritis should include an initial comprehensive pain assessment and ongoing assessment of pain and functional status to identify, implement, and
Advances in the treatment of RA have shown that active drugs should be given as soon as possible [1, 2]. This idea has been framed in the concept of a window of opportunity for the best results, window that extends only for the first months since symptoms onset [3-6]. The benefits of treatment in this window include increased response rates, decreased disease activity, prevention of bone erosions, less disability, increased rates of remission, even of drug-free remission, and larger improvement in health quality scores [3-6]. These benefits are of large significance, but are demanding for the rheumatologist because often it is difficult to diagnose RA when the first symptoms appear. This task has been facilitated by the development of new RA classification criteria in 2010 . These criteria aim to define patients earlier in the disease course than the 1987 ACR criteria .
Arthritis is a joint disorder, which affects one or several joints in the body. The condition has more than one hundred types of diseases with osteoarthritis being the most common. Osteoarthritis results from joint infection, or age. Patients that suffer from arthritis complain about pain in the joints. In most cases, the pain remains constant in the affected joint. It is worth noting, “The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff painful joints and fatigue” (Reid, Shengelia & Parker, 2012, p. 40). However, joint pain could result from various diseases, and in such