Can rheumatoid arthritis be cured?
Posted on 1 March 2022
Untreated rheumatoid arthritis results in chronic inflammation and damage to joints. While no cure exists for this potentially debilitating disease, early detection and advances in treatment mean most patients can expect excellent outcomes.
What causes rheumatoid arthritis (RA)?
RA is an autoimmune disease caused by a combination of a genetic predisposition to the disease and exposure to an environmental agent, explains rheumatoid arthritis specialist Dr David Gotlieb of Mediclinic Constantiaberg in Cape Town. The latter could be because of an infection that occurred many years before the first RA symptoms appear.
Women are most at risk, as well as people of both genders with a family history of RA, smokers, and those with an increased risk from chronic infections. Certain bacteria in the bowel that interact with the patient’s genetic profile are also thought to play a focal role.
What are the most common symptoms?
- Swelling in the joints and surrounding tissues, most commonly in the wrist, fingers, knees, feet, and ankles.
- Stiffness, especially morning stiffness that lasts more than 30 to 60 minutes.
- It may start in a single or multiple joints, then spread, affecting multiple joints on both sides of the body in a symmetrical distribution.
- The neck may be involved, but not the lower back.
How is RA diagnosed?
A clinical diagnosis is made, based on an examination and an evaluation of the presentation and history of symptoms.
“Early on, blood tests and X-rays may be completely normal, and X-rays will only show damage over time,” Dr Gotlieb says, which is why early diagnosis and treatment are so important.
RA is a systemic condition that can also affect other organs, such as the eyes, blood vessels, muscles, and nerves. In addition, it increases the risk of heart disease, certain types of cancer and, if left untreated, will reduce patients’ lifespan.
How is it treated?
Since there’s no cure, the focus is on early diagnosis and using medication to arrest the disease and put it into remission, while also treating systemic conditions.
- Analgesics and anti-inflammatories are used to treat the symptoms.
- Synthetic disease-modifying antirheumatic medication (DMARDs).
- Biologic drugs designed to suppress inflammatory chemicals are often used in patients with progressive or active disease, despite disease-modifying therapy.
- Low-dose cortisone therapy and cortisone joint injections.
- Surgery is becoming rare and is only used for damaged joints where medical treatment is no longer effective.
Positive outlook for RA patients
Dr Gotlieb says ongoing research into all the known immune pathways involved in inflammation is ongoing. However, an urgent issue is patient access to treatment.
A study published in the Scandinavian Journal of Rheumatology showed that in South Africa, RA patients can wait up to a year to be diagnosed, by which time their condition has degenerated significantly. Mediclinic is committed to stepping into this gap and offering people from all corners of the country world-class RA treatment.
“The age of the wheelchair is over and today our RA patients who get early access to sustained treatment, are expected to have a full and functional life,” assures Dr Gotlieb.