What is Rheumatoid Arthritis?
Rheumatoid arthritis, like all the diseases addressed by the European DocTIS project, is an immune-mediated inflammatory disease (IMID). It’s a chronic inflammatory condition with unknown causes, which makes prevention unattainable.
In 2019, the World Health Organization reported that 18 million people worldwide were affected by rheumatoid arthritis, though estimates suggest about 1% of the adult population suffer from it. The disease predominantly affects women (70%) compared to men (30%), often appearing between the fourth and fifth decades.
Rheumatoid arthritis typically presents in flare-ups, interspersed with periods of remission. Common symptoms include:
• Joint pain, inflammation, and stiffness.
• Fatigue, fever, and loss of appetite.
Initially, it affects the hands, wrists, ankles, and feet, particularly in the morning. Sustained inflammation causes cartilage loss as well as articular bone erosions that impair normal daily tasks and cause pain. As the disease progresses, it may involve other joints like knees, elbows, shoulders, or hips, potentially leading to joint deformities and impaired movement.
Diagnosis usually begins with a physical examination to check for joint inflammation, redness, or elevated temperature, and to assess movement. This is followed by general tests (blood and joint fluid analysis) and imaging techniques like X-rays, ultrasounds, or MRIs.
Rheumatoid arthritis is caused by a malfunctioning immune system that mistakenly attacks healthy joint tissues. The exact trigger for this process remains unknown, but genetic factors are believed to play a role, which might explain the higher prevalence in women and the increased risk for those with a family history of the disease. Lifestyle factors such as smoking and obesity also elevate the risk.
Currently, there is no cure for rheumatoid arthritis, but treatments are available to alleviate symptoms, enhance joint mobility, and improve daily functioning. Early diagnosis allows for earlier therapeutic intervention and can more effectively slow disease progression and help prevent disability. Regular physical activity and physiotherapy can significantly improve quality of life by maintaining joint flexibility and strengthening muscles.
Common treatments for rheumatoid arthritis include:
• Medications:
o Non-steroidal anti-inflammatory drugs (e.g., ibuprofen) to reduce pain and inflammation.
o Glucocorticoids, which have strong anti-inflammatory effects.
o Disease-modifying antirheumatic drugs (DMARDs) to slow disease progression and prevent permanent damage.
o Targeted therapies: biological agents and small molecules which have a highly specific mode of action and can be very efficacious in reducing disease activity in some patients.
• Surgery: In severe cases, to repair, fix, or replace affected joints.
To date, targeted therapies are the most efficacious way to control disease in rheumatoid arthritis but they are successful only in a fraction of patients. Furthermore, even in those patients where they are initially useful, they may lose efficacy with time.
The DocTIS project aims to leverage the specificity and efficacy of modern targeted therapies. By combining therapies that are highly complementary, we aim to better alleviate symptoms in patients and also prevent the loss of efficacy not only in rheumatoid arthritis but also in five other IMIDs: psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis, and systemic lupus erythematosus.
(Above image by Freepik)
