"Winning the War Against Rheumatoid Arthritis"
RA is a condition that forces half of patients to become disabled from the work force within five to ten years? and reduces life expectancy by as much as 18 years. RA affects about one per cent of the world's adult population, most commonly women between the ages of 30 and 50.
The good news is that a tremendous amount of progress has been made within the last ten years in identifying patients earlier and treating the disease more aggressively. Patients with RA, if treated appropriately, can lead a relatively normal life. This is in stark contrast to the wheel-chair bound existence common as recently as 20 years ago!
Experts in the field consider early rheumatoid arthritis to be a medical emergency with mortality and morbidity equal to that for diabetes, asthma, heart disease, and other life-threatening conditions.
Rheumatoid arthritis attacks the joints in a symmetric fashion (both sides of the body affected equally) with the most common areas being the hands, wrists, ankles, knees, and feet. In addition to the swelling and pain, patients with RA often have profound fatigue and stiffness.
Rheumatoid arthritis is an autoimmune disease that attacks not only joints, but internal organs such as the blood vessels, lungs, heart, and eyes. Patients with RA are at increased risk for heart attack, stroke, and lymphoma.
Since many other types of arthritis such as gout, lupus, and osteoarthritis can look like RA a careful diagnostic approach is needed.
Laboratory testing has its pitfalls. The rheumatoid factor, a blood test found to be positive in about 80 per cent of individuals with RA, may also be positive in other disease conditions. Couple that with the fact that 20 per cent of patients with RA will be rheumatoid factor negative, then it becomes clear a diagnosis should not hinge on the results of blood tests alone.
Imaging procedures can also be misleading. Conventional x-rays often miss the erosions found with early disease. Newer imaging technologies such as magnetic resonance imaging (MRI) and ultrasound are much more sensitive.
After the diagnosis is made, there is even more hope for a patient today. In the past, non steroidal anti-inflammatory drugs (NSAIDS) used to be considered a cornerstone of therapy. That is no longer true.
Disease-modifying anti-rheumatic drugs (DMARDS) are being used earlier. Among the DMARDS currently being used are methotrexate, leflunomide (Arava), azathioprine (Imuran), sulfasalazine (Azulfidine), cyclosporine, and hydroxychloroquine (Plaquenil). These drugs attack the immune cells responsible for chronic inflammation. While DMARDS alone in combination are effective, they are relatively non-specific. Often, combinations of DMARDS are required.
Biologic Response Modifiers (BRMS) can target the disease more specifically than DMARDS. RA is a disease that is dependent on the signaling that occurs between immune cells. The signaling takes place through the use of special chemical messengers called cytokines. BRMS act at both the cytokine (chemical messenger) as well as the cellular level allowing the disease to be better controlled and in some instances put into remission.
Biologic response modifiers, which include drugs that suppress tumor necrosis factor (TNF), appear to be particularly effective.
Tumor necrosis factor is a protein that is produced by the immune cells. TNF is the major culprit responsible for inflammation-inducing damage. By block the effects of TNF, better control of RA can be achieved.
Three anti-TNF drugs are currently available: etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade). Another biologic drug, anakinra (Kineret) blocks interleukin, a different cytokine.
These drugs allow patients to have their disease controlled to such an extent that most are able to enjoy a normal work and leisure existence.
On the horizon are other biologic drugs that work at different points in the immune system- on different cytokines and on different pathways- to allow even greater as well as more specific control of disease. Since rheumatoid arthritis is a disease with many different cytokine and cellular mechanisms responsible for damage, attacking the disease at different points makes sense. In the future it may be possible to identify patients through specific tissue signals (called "biomarkers"). These biomarkers will allow physicians to type patients and give patients the specific therapy that will work best for them. Once that is achieved, the possibility of a cure becomes a reality.
Everything, though, starts with early accurate diagnosis. If damage is allowed to occur the chances for remission drop dramatically!
Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com
This RSS feed URL is deprecated, please update. New URLs can be found in the footers at https://news.google.com/news
MRI scans shows promise in predicting dementia - Washington University School of Medicine in St. Louis
Stanford Medicine magazine reports on ways digital technology is transforming health care - Stanford Medical Center Report
Marketing Authorisation - Medicinal Products
Marketing Authorisation: Medicinal Products The case of R (on the application of Merck Sharp and Dohme Ltd) v Licensing Authority , concerned the application for marketing authorisation for a generic product which was based on Product C (see below).The claimant had marketing authorisations for three medicinal products used in the treatment of osteoporosis and three generic companies sought marketing authorisation for Product C.
Mexico: Drugs Galore!
You are going to find this incredible and I assure you I am not making any of this up: You can waltz into any pharmacy (Farmacia) in Mexico and buy almost anything without a prescription. Except for controlled substances, you can get most anything you want or need simply by asking.
The Check Doctor Credentials Theory
In 2003, there where more than 890 million doctor visits in the U.S.
Zyprexa Side Effects are Deadly: Effects Include NMS
Zyprexa is a prescription drug that treats schizophrenia, acute mania and bipolar disorder. It is a psychotropic drug that treats the psychotic disorders of the mind but unlike other drugs for psychotic disorders, Zyprexa is an atypical antipsychotic.
Flatfeet in Children: When Are They A Problem?
There are high arch feet and low arch feet and many different foot types in between. Many individuals have flatfeet, but do not have foot problems.
Potassium and The Dialysis Patient
Any dialysis patient who has had a brush with high potassium will know only too well how dangerous this can be. We are forever being told to watch our potassium intake, so I thought I would explore the reasons for this, and what practical steps we can take to limit the risks.
Vioxx Personal Injury Lawsuits
Personal injury attorneys representing clients who have allegedly been harmed by the prescription drug Vioxx are congratulating themselves over a historic judgment rendered recently. On August 19, 2005, a judge awarded the family of Bob Ernst $253.
"Foot Pain Relief At Last!"
"As an arthritis specialist, one area that I see people complain about more often than almost any other, is their feet." So says Dr.
Are You Sometimes Confused by Written Medical Instructions?
Now, imagine what it would be like if you were sick, scared and had only third grade reading skills. Your doctor tells you, "You've got to follow these instructions exactly, or you could die.
Paxil Recall Lawyer Discusses Paxil Addiction
Paxil went on the market in 1992 at the height of antidepressant drug popularity. It is a member of the class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.
Phentermine Diet Pills: When Diet and Exercise Arent Enough To Help You Lose Weight
Have you been struggling to lose weight, but diet and exercise aren't giving you the results you need to be healthy? Are you sick of people telling you that you could lose weight if only you had the will-power? It may be time to ask a physician about a phentermine prescription.What is Phentermine?Remember those 50s movies in which women lost weight by taking amphetamines? We know now that amphetamines can be very dangerous, so they don't make safe weight-loss drugs.
Benefits of a Virtual Top Doctor Consultant
Looking for the best doctor to suite your medical needs can be a problem, especially if you don't have time and you need to research the doctor's credentials. Whether you're in urgent need of help, or just need a second opinion, I will show you how to access all the information you need - through the Internet's Virtual Top Doctor Consultant.
Considerations in Distance Education for the Medical Assistant Instructor
Medical Assistant distance education is emerging to meet the demands of a new generation of students in the twenty first century. St.
Lunesta is a newly released sleeping pill. Marketed as a revolutionary sleep aid, Lunesta is the only medication approved by the FDA for long term treatment of insomnia symptoms.
Serzone Side Effects Lead to Serzone lawsuits
Serzone is a prescription medication that is given to patients who are seriously depressed (Dysthymia,Major Depression, and Bipolar Disorder) to alleviate the symptoms of depression such as sleep and eating habits, changes in weight, coordination, fatigue, unjustified feelings of worthlessness or suicidal thoughts which prohibit normal functioning. It balances levels of serotonin and norepinephrine in the brain which doctors think will help alleviate symptoms of depression much like the phenylpiperazine antidepressant, Trazodone (Desyrel).
Top Ten Reasons Why We Hate IBS!
Irritable bowel syndrome can be a nightmare?constant diarrhea and terrible stomach pains, or unbelievable constipation and never-ending gas. While it's good to stay positive and keep looking for help, sometimes it's even better to just have a good old moan!So, without further ado, I would like to present the top 10 reasons why we all hate IBS.
Exposing the Miracle Cure
It was Saturday morning and while I was making breakfast, letting the cats outside, and watering my half-dead plants, I had the TV on. Saturday morning TV is usually composed of nothing but infomercials and today was no different.
Hypothermia - The Cold Facts
If you ever go to cold countries, you should undoubtedly have heard of Hypothermia. If you haven't, you should learn something about it.
CRP And Your Heart
Monitoring your CRP level is vitally important because it is one of the best indicators of heart disease. C-Reactive Protein has proven to be one of the best indicators of looming Heart disease.
What is Bextra? (FDA Recalled Drug)
Bextra, also known as valdecoxib, is a prescribed medication used to alleviate the problems associated with arthritis and other inflammation-related conditions. The drug helps reduce the pain of swelling and fever without causing stomach irritation like aspirin.
|home | site map | Dr. Thad Thomas|