The following PowerPoint presentation provides basic information about RA and outlines the importance of this issue to state legislators.
Frequently Asked Questions:
- What is Rheumatoid Arthritis?
- How prevalent is Rheumatoid Arthritis?
- Who are the at-risk populations affected by Rheumatoid Arthritis?
- What causes Rheumatoid Arthritis?
- What are the symptoms of Rheumatoid Arthritis?
- What can prevent and control Rheumatoid Arthritis?
- What tests can be conducted to detect Rheumatoid Arthritis?
- What are the implications of Rheumatoid Arthritis on America’s public health?
- How can I learn more about Rheumatoid Arthritis?
- What is the difference between Rheumatoid Arthritis and Osteoarthritis?
What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease affecting 1.3 million individuals. RA causes joint swelling, pain and stiffness often in several joints. Generally joints are affected bi-laterally, so that if one knee or elbow is affected the other is too. RA has no known definitive cause, though it is thought that genes, hormones and perhaps the environment may play a role in its onset. It affects two to three times more women than men, often developing between 20 and 60 years of age with incidence increasing with age. Progression of the disease often leads to joint deformity and loss of function, which may occur within one to two years of disease onset.
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How prevalent is Rheumatoid Arthritis?
Data on the incidence and prevalence of Rheumatoid Arthritis is limited. Most data is aggregated into a general incidence of arthritis, not distinguishing between types.
It is estimated that 1.2 million Americans have RA (year 2005 data). Two to three times more women than men have the disease. Rheumatoid arthritis generally occurs between the ages of 30 and 60; however it can occur at any age. Approximately 5% of persons over 55 years of age are diagnosed with RA. The average annual incidence of RA in the U.S. is 70 per 100,000 individuals.
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Who are the at-risk populations affected by Rheumatoid Arthritis?
Rheumatoid Arthritis is an autoimmune disease with no known definitive causative agent. However, certain risk factors for arthritis have been identified, including gender, tobacco use and race. Approximately, 61% of all arthritis patients are women; this is consistent with reports that there is a two to three times higher incidence of RA in women than in men. Asian ethnicities have lower rates of RA, while American Indians and Native Alaskans have higher rates when compared to Caucasians and African Americans. A history of smoking has been associated with a 1.3-2.4% increased incidence of RA.
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What causes Rheumatoid Arthritis?
RA has no known definitive cause, though it is thought that genes, hormones and perhaps the environment may play a role in its onset.
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What are the symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis often begins unremarkably with flu-like symptoms, such as low-grade fever, malaise, loss of appetite, morning stiffness and fatigue. Sometimes these symptoms occur over several weeks or months prior to the development of joint swelling and pain. Patients with RA may experience a waxing and waning of symptoms at the onset of the disease making diagnosis difficult. Adding to the uncertainty regarding this illness, some patients may experience symptoms for only a short period while others have RA for years or their entire life-time. Other symptoms of RA may include:
- Anemia
- Eye burning, itching, and discharge
- Limited range of motion
- Lung inflammation (pleurisy)
- Nodules under the skin
- Numbness or tingling
- Paleness
- Skin redness or inflammation
- Swollen glands
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What can prevent and control Rheumatoid Arthritis?
Currently, there is no cure for RA; however, significant strides have been made in treating the symptoms. There is no one way to treat RA. Treatments may involve a combination of medications, alternative medicines such as herbs and acupuncture and possibly surgery. Medications may include combinations of anti-inflammatory and anti-rheumatic medications, steroids and other symptom-reducing drugs including biologic agents.Research indicates that some biologics slow disease progression markedly for up to 7 years . Biological products include a wide range of products such as vaccines, blood and blood components, allergenics, somatic cells, gene therapy and recombinant therapeutic proteins. Surgery may be necessary to reduce joint deformity and increase joint mobility and function.
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What tests can be done to detect RA?
A specific test is available to identify Rheumatoid Arthritis as the cause of illness. This test determines the presence of an antibody associated with RA; it is called the anti-CCP antibody test[2]. Another test which may be ordered is the Rheumatoid Factor test which results positive in 70-90% of individuals with Rheumatoid Arthritis[3]. Other tests may be ordered by a physician to support the diagnosis or to rule-out other health issues; however, these two tests are the most often used by physicians to diagnose RA.
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What are the implications of RA on America’s public health?
Nearly 41% of adults with an arthritis diagnosis report arthritis-attributable activity limitations[4]. Disability is higher among patients with rheumatoid arthritis with 60% being unable to work 10 years after the onset of their disease[5]. Of adults aged 18-64 with doctor-diagnosed arthritis 30.6% report an arthritis-attributable work limitation[6]. Among adults with arthritis, many report significant limitations in common daily activities such as[7]:
- walking 1/4 mile—6 million
- stooping/bending/kneeling—7.8 million
- climbing stairs—4.8 million
- social activities such as church and family gatherings—2.1 million
Recent studies have demonstrated an increased mortality in rheumatoid patients. The people with RA are two times more likely to die than people of the same age in the general population. Median life expectancy was shortened an average of 7 years for men and 3 years for women with rheumatoid conditions compared to control populations[8].
Individuals with arthritis report more than twice as many unhealthy days and three times as many days (per month) with activity limitations than those without arthritis[9]. Additionally, 18.1% of individuals with arthritis also have major depression[10].
Three categories of Arthritis and Other Rheumatoid Conditions (AORC) account for almost 80% of deaths: diffuse connective tissue diseases (34%), other specified rheumatic conditions (23%), and rheumatoid arthritis (22%)[11].
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How can I learn more about Rheumatoid Arthritis?
Click here to visit our Online Resources which lists government and nonprofit organizations working to fight RA.
What is the difference between Rheumatoid Arthritis and Osteoarthritis?
|
|
RHEUMATOID ARTHRITIS
(RA) |
OSTEOARTHRITIS
(OA)
|
|
TYPE OF DISEASE
|
Chronic, systematic autoimmune disease in which the joint’s lining becomes inflamed, continues indefinitely & can affect other organs |
“Wear-&-tear”
Chronic, degenerative condition in which the joint’s cartilage breaks down |
|
PREVALENCE
|
Approximately 1.3 million Americans
|
Approximately 27 million Americans |
|
INCIDENCE
|
Between 20 & 60 years of age
2 to 3 times higher in women than men
|
Middle-aged & older people – mostly after age 45 years |
|
SYMPTOMS
|
Joint pain, swelling, stiffness, flu-like symptoms & decreased range of motion during the morning when first waking up generally targets pairs of joints (hands, ankles & knees)
|
Joint stiffness, pain & decreased range of motion during the evening or after activities generally targets knees, hips, fingers, neck & lower back
|
|
CAUSE
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No known cause
|
No single known cause:
Primary OA – associated with age
Secondary OA – an apparent cause |
| RISK FACTORS |
Genetics, hormones & environmental factors (such as smoking)
|
Age, obesity, injury or overuse, genetics, muscle weakness & other diseases (such as RA) |
| DIAGNOSIS METHOD |
Medical history, physical exam, X-rays & lab tests
|
Medical history, physical exam, X-rays & MRI |
| TREATMENT |
Medication, surgery & several others
|
Medication, physical & occupational therapy, surgery, exercise & several others [12] |
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[1] National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Data and Statistics. “Arthritis Related Statistics.” Accessed online: http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistic....
[2] Medline Plus. National Institutes of Health and U.S. National Library of Medicine. “Medical Encyclopedia: Rheumatoid Arthritis.” http://www.nlm.nih.gov/medlineplus/ency/article/000431.htm
[3] The Johns Hopkins Arthritis Center. Rheumatoid Arthritis Clinical Presentation. Alan K. Matsumoto, Ed. Accessed online: http://www.hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rhe.... Also Medline Plus. National Institutes of Health and U.S. National Library of Medicine. “Medical Encyclopedia: Rheumatoid Arthritis.” Accessed online: http://www.nlm.nih.gov/medlineplus/ency/article/003548.htm.
[4] National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Data and Statistics. “Arthritis Related Statistics.” Accessed online: http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistic....
[5] The Johns Hopkins Arthritis Center. Rheumatoid Arthritis Clinical Presentation. Alan K. Matsumoto, Ed. Accessed online: http://www.hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rhe....
[6] National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Data and Statistics. “Arthritis Related Statistics.” Accessed online: http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistic....
[7] Ibid.
[8] National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention (2009). Arthritis. “Arthritis as a potential barrier to physical activity among adults with diabetes, United States, 2005 and 2007.” Accessed online: http://www.cdc.gov/arthritis/
[9] National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Data and Statistics. “Arthritis Related Statistics.” Accessed online: http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistic....
[10] Ibid.
[11] Ibid.
[12] Arthritis Foundation www.arthritis.org - Centers for Disease Control and Prevention www.cdc.gov
