Rheumatoid arthritis (RA) is one of the most common rheumatic diseases known as inflammatory rheumatism. Although the frequency varies, there is a risk of developing the disease in one person out of 200-400 people. Although it is slightly more common in women, there is no significant gender difference. Although RA is more common in women between the ages of 40-50, it can be seen in any age and gender.
What are the Complaints of the Disease?
The disease generally has an insidious onset. The patient’s complaints mainly occur at night and in the morning. Weakness and fatigue often accompany it. Mild fever may also be present from time to time. The small joints of the hand and the wrist are the most frequently involved areas. More rarely, the disease exhibits a very rapid onset. While the patient does not have any complaints when he goes to bed at night, he wakes up in the morning with all his joints swollen and painful. Patients generally feel better 1-2 hours after getting up in the morning and moving. Sometimes, a single joint of the patient swells, and then other joints begin to swell. Joints often exhibit a symmetrical involvement.
Although RA is predominantly a joint disease, it can affect many organs. It may show dryness in the eyes, dry mouth, and involvement in the lungs. Sometimes, it can lead to a severe picture that we call vasculitis by holding the vessels.
If RA is not treated, it can cause serious joint deformities, disability and problems ranging from disability.
How is the Diagnosis of the Disease Made?
The type of patient’s complaints, joint involvement and onset are of great importance in the diagnosis of the disease. That is, the information that the patient will give is very important. Since the joints to be affected by the disease will usually be the same, it is usually not difficult to diagnose. However, in some cases, it may present with rare joint involvement.
Blood tests are very useful in diagnosing RA. However, blood tests are not only helpful in making the diagnosis, but also in the follow-up of the disease and in evaluating the side effects that may develop due to the drugs used. Tests that are not very specific for the disease, such as inflammation tests, are often elevated. However, the test called rheumatoid factor and anti-cyclic citrulline peptide (anti-ccp) is more specific for the disease. These tests are positive in approximately 70-80% of patients.
How is the disease treated?
In the treatment of RA, we can evaluate it under three headings as drug, non-drug and surgical methods.
Non-drug methods generally include losing excess weight, exercising, and quitting smoking, which we know increases the severity of the disease. Smoking definitely increases the severity of the disease.
There have been great changes in RA drug treatment in the last 10 years. An old drug called methotrexate is the first drug of choice for the disease all over the world. Methotrexate is given to patients sometimes alone or in combination with other main drugs.
Developments in recent years have mainly been in the field of drugs called biological therapies. With these drugs, it is aimed to stop inflammation by targeting a cytokine or cell in the body.
It cannot be predicted how long these drugs will be used. It usually needs to be used for a long time. After the disease is in remission, the doses or numbers of drugs are manipulated.
Some selected patients require surgical intervention. However, as I said, this applies to very few patients.
The most important point to be said in terms of treatment is proper follow-up, regular control and follow-up by a rheumatology specialist, rather than which drug is used in this disease.
