Rheumatoid arthritis (Part 3): biological therapy

Rheumatoid arthritis is a serious condition that affects work capacity. Visceral lesions are responsible for shortening the average life of 5 to 10 years. Major consequence of this disease is disability. The loss of work ability is the most costly consequence of early rheumatoid arthritis.

Try to treat early rheumatoid arthritis. Despite major advances in the field of therapy, so far there is no known cure for rheumatoid arthritis, as neither prophylactic methods. Optimal treatment of disease require early diagnosis and timely use (ie early enough), to reduce the probability of irreversible joint injuries. It is very important to treat a patient early, when symptoms do not evolve more.

Progress in recent years in understanding the pathogenic mechanisms of disease led to major developments necessarily to treat rheumatoid arthritis. Recognizing the central role of cytokines in particular TNF-alpha in rheumatoid synovium of hypothesis testing led to the control of rheumatoid arthritis by blocking TNF-alpha.

Biological therapy (anti-TNF agents)

Clinical studies in recent years have demonstrated that the TNF alpha blockers cause a rapid and significant improvement of the clinical disease (pain and inflammation), creating thereby a substantial improvement of life quality of patients treated, but also a unique effect of stopping the progression of radiological (joint structural damage) characteristic of the disease.

TNF blockers are indicated in patients with rheumatoid arthritis, despite a complete and correct therapy. TNF blockers slow or even stop disease progression, if is used early (before the onset of osteoarticular lesions).

TNF blockers can be administered only under the supervision of an experienced physicians in the diagnosis and treatment of rheumatoid arthritis, including evaluation:
* Disease evolution
* Efficiency and tolerance of immunomodulatory therapies.

Before initiation by setting specific goals for each patient. Your doctor will do a complete examination, including a Rg. chest to exclude any contraindications.

Contraindications. Use of TNF blockers is contraindicated in cases of acute or chronic infections (including tuberculosis) or recent cancer. Their appearance during treatment. require discontinuation, which will be resumed only after complete cure.

For monitoring the effectiveness of therapy:
* Assessing the number of swollen and painful joints;
* Determination of acute phase reactants (ESR and CRP);
* Global assessment of disease evolution by the physician and the patient (visual analogue scale or a scale with five degrees);
* Assessment of joint pain (visual analogue scale 100 mm);
* A functional assessment (such as Haq).

Based on understanding the molecular mechanism of disease, anti-TNF therapy opens a new era in the treatment of rheumatoid arthritis.

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Rheumatoid arthritis (part 2): symptoms treatment

The disease symptoms appear and disappear, depending on the degree of inflammation of the joints. When tissues are inflamed the condition is active and when not feeling joints inflamed, disease is inactive, can occur spontaneously or after treatment, and maylast several weeks, months or years.

During the liberation, the disease symptoms disappear and, in general, patients feel better. When the disease symptoms recur, reappearance of disease symptoms is called burst. When disease is active can occur tiredness, lack of appetite, fever, pain and stiffness in their joints and muscles. Rigidity of muscles and joints, usually occurs in the morning and after periods of inactivity.

During outbreaks joints are swollen, painful and sensitive. It happens so because joints become inflamed, resulting in excessive production of liquid. In rheumatoid arthritis, are usually more swollen joints in symmetrical fashion (the same body part). And small joints are involved, such as those in hands or feet. Thus, ordinary activities, daily, such as door handles or opening jars can become almost impossible during outbreaks.

Occasionally, only one joint is inflamed, and in this case can mimic arthritis joint inflammation caused by other forms of arthritis such as gout or joint infection. Chronic inflammation can cause damage to body tissues, and bones. This situation leads to loss of cartilage, bone erosion and weakening, resulting in joint deformation but also the destruction and loss of functionality.

In rare cases, rheumatoid arthritis may affect joints responsible for stretching the vocal cords, change the tone of voice, in this case is hoarseness of voice. Because rheumatoid arthritis is a systemic disease, inflammation can affect organs, other than joints.

Swollen glands of the eyes or mouth can cause dryness of these areas, giving rise to Sjogren's syndrome. Rheumatoid inflammation of lung pleura causes chest pain with cough and difficulty breathing. Inflammation of the tissues that surrounds the heart (pericardium), called pericarditis can cause chest pain that typically changes in intensity when you rest or sit.

A serious complication that occurs over time after the onset of rheumatoid disease, is blood vessel inflammation (vasculitis). Vasculitis deteriorating tissues with blood supply, leading to their death.

Treatment. Rheumatoid arthritis treatment aims to reduce inflammation and joint pain. Aggressive treatment can improve function and can stop joint damage. Optional treatment involves a combination of medicines to rest, exercise, joint protection and patient and family education. Also, the treatment is prescribed depending on many factors such as your job, types of joint involved, general health, age and occupation of the patient.

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Rheumatoid arthritis (part 1): general Information

Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation among joints, tissues around the joints and internal organs. Autoimmune diseases occur when body tissues are mistakenly attacked by its own immune system.
The immune system is a complex of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections.
Patients with autoimmune diseases have antibodies in their blood that attack their own body tissues; they can be associated with inflammation. Because it can affect other organs, rheumatoid arthritis refers to a systemic illness and is sometimes called rheumatoid disease.
When rheumatoid arthritis a chronic, which means it can take years, patients may experience a long period of time with no symptoms. Typically, rheumatoid arthritis is a progressive disease that has the ability to destroy joints.
A joint is where two bones meet to allow movement of body parts. Arthritis means joint inflammation. Joint inflammation of rheumatoid arthritis causes swelling, pain, stiffness and redness. Inflammation of rheumatoid disease can also occur in tissues around the joints, such as tendons, ligaments and muscles.
In some patients with rheumatoid arthritis, chronic inflammation leads to destruction of cartilage, bone and ligaments causing deformity of joints. Studies have shown that progressive damage to the joints does not necessarily correlate with pain, stiffness or swelling in joints.
Rheumatoid arthritis is a rheumatic disease three times more common among men than women. The condition can be triggered at any age but often occurs in people who have passed the age of 60 years.
The causes that trigger this disease are not yet known. Although infectious agents, such as viruses, bacteria and fungi have been suspected as possible causes, this assumption proved to be false. Some researchers believe that infections or environmental factors may result that immune system to attack the body tissues, resulting in inflammation among several organs of the body, such as eyes and lungs.
Whatever the cause, the result is the same: an immune system that allows joint inflammation and swelling occasionally. Surrounding factors seem to play a role in causing rheumatoid arthritis. Recently, scientists reported that smoking increases the risk of developing the disease.
Degree of joint destruction of rheumatoid arthritis varies according to each patient. Patients suffering from a mild form of rheumatoid arthritis, occur after several years of activity, can be treated with anti-inflammatory drugs and some rest. In general, joint function are improved when the patient is treated early, with slow-acting drugs.

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