Statistics show that 30% of the world population may suffer from some form of arthritis, but only 20% consult the specialist for severe symptoms.
From A to Z All you need to know about Rheumatoid Arthritis!
* 50% of people with rheumatoid arthritis can develop functional disability and 20% of total disability but are treated on time, being a more frequent cause of limitation than heart disease, cancer or diabetes mellitus.
* Up to half of the patients with RA (rheumatoid arthritis) may be out of the workforce, being this disease one of the most incapable in the world at the full productive age
The diagnosis is suspected with the patient's symptoms, which are pain in the joints, accompanied by stiffness in the same hours of the morning, inflammation or swelling of the joints. The most affected sites are the hands and feet, followed by sites such as shoulders, elbows and knees. The doctor should check for inflammation in the joints. Some laboratory tests confirm the diagnosis. Some patients
May not have these positive tests (rheumatoid factor, anticitrulin antibodies) and still have the disease.
Symptoms of alertness:
Pain. The pain is inflammatory, has the following characteristics: it is stronger in the morning when the patient is raised, improves with the course of the day; Is accompanied by rigidity, which is greater than one hour. In severe cases, the pain can wake the patient at night or not let him sleep.
Swelling or swelling of the joints most evident on hands and knees. Other symptoms: tiredness and weight loss.
They do not know each other. It is presumed that some infectious agent can trigger the disease, but this has not been proven. In any case, it is known
Or what happens at the level of the immune system, which causes the development and perpetuation of the disease.
There are genetic factors that make an individual who has genetic susceptibility, develop the disease in the presence of environmental factors. The inheritance in arthritis and diseases of the same type, is known as "polygenic inheritance", that is to say that heredity is associated with environmental factors. A very important environmental factor for the development of arthritis is the cigarette. The cigarette alters certain proteins that precipitate the disease. A person with a family history of rheumatoid arthritis and who smokes, multiplies by ten the risk of having this disease, a risk that is only multiplied by four if they do not smoke.
Rheumatoid arthritis, affects more women in a ratio of 3 women per 1 man. The age at which it appears most (peak incidence) is at age 40 which does not mean that it does not appear in younger people and in older individuals even in the third age.
Parts of the body most affected by the presence of RA-rheumatoid arthritis:
Arthritis most affects the joints producing inflammation which is reversible in the early stages. With inflammation, substances that damage the cartilage, and other structures of the joints are produced. If the inflammation is continuous, joint damage, deformity and disability occur. Other organs that may be affected:
- Eyes: lack of lubrication or dryness as a frequent associated symptom in arthritis. Dry mouth can be associated with lack of saliva production, known as Sjogren's syndrome.
- Lungs (there may be inflammation of the lung tissue that manifests from shortness of breath)
It is mainly based on the use of medications and its purpose is to stop the inflammatory process that damages the joints. To this end, combinations of drugs that act at different levels should be used:
- Treatment of pain: painkillers such as acetaminophen or nonsteroidal anti-inflammatory drugs, the latter being used during crises and for a short time.
- Derivatives of cortisone: are excellent anti-inflammatory and very useful in case of severe crisis of the disease. Low doses may be used for a long time if the patient requires it, taking all measures to avoid side effects. There is discussion as to its long-term benefits.
- Disease modifying drugs: they are the cornerstone of treatment. They are slower acting, resulting in medications from the first two groups at least at the beginning of treatment. They allow to reverse the inflammatory process and the objective with its use is that the patient enters a state of "remission of the disease".
- Biological therapy: they are modifying agents of high technology, they are administered subcutaneously or intravenously. They are of high cost and are reserved for patients who have not responded or do not tolerate modifying medications.
- Treatment follow-up: To achieve the goal of remission, parameters and measures have been established for which the group of rheumatologists has been trained (T2T strategy).
The treatment is usually undefined. There is an impressive development of medications for rheumatoid arthritis, over the last decade. The knowledge of the mechanisms that generate the disease, has allowed the development of molecules very specific for the treatment of this disease. Since 1999, 8 arthritis medications have been on the market. They belong to the biological therapy group.
Importance of remission of RA patients in a timely manner to the specialist:
This is a very important factor. Rheumatoid arthritis is a chronic, aggressive disease that causes pain, joint damage, and disability. The goal of treatment is to prevent joint damage and disability. Today we know that early appropriate treatment is critical to preventing these outcomes. The earlier you start the treatment the better; We talked about a window of opportunity to obtain the best results and this has been established around the first 3 months after the onset of symptoms. Not all patients with recently started arthritis will develop rheumatoid arthritis, 40% of them will have what is called undifferentiated arthritis with a different prognosis: greater chance of complete improvement and little likelihood of joint damage; A percentage of patients, may develop another type of arthritis.
Most visible limbs of a patient with rheumatoid arthritis:
Limitations caused by joint involvement. Patients with arthritis may have different degrees of inability to perform various activities of daily living. These are evident when the disease is uncontrolled and improved with treatment. Rheumatologists have tools (questionnaires) to evaluate the commitment of the patients' physical function and to follow up.
Myths about this disease
The most mentioned is that of food. It has not been shown that a food or food group triggers or worsens the disease. There are also myths about the use of certain substances that can not be called drugs, which are useful for treatment (magnesium chloride for example).
Developed this disease ... is it reversible?
Only 5% of patients with arthritis have symptoms and then improve. In most patients, this disease is chronic and progressive. Some patients present what we know as exacerbations and remissions. May this important PANLAR event be the date to remember the importance of early diagnosis to treat a disease that affects not only adults but children and with which to learn to live, not only the patient but his family.
Real Project - Panlar implementation and accreditation of Centers of Excellence in Rheumatoid Arthritis in Latin America
In Latin America and the Caribbean, there is a worrying number of patients with rheumatoid arthritis who have unsatisfied needs for accessibility to specialist consultation and appropriate treatment. One reason is the limited number of specialists (rheumatologists) available to the general population, which causes a number of patients to access the rheumatologist's care very late in the advanced stages of the disease. This also leads patients to timely failure to receive DMARDs (ie, specialized drugs to treat DMARDs) and probably also have limited access to rehabilitation or education programs that they and their families need for appropriate management of the disease. disease.
The REAL - PANLAR project originates from the strategic need for the implementation of Centers of Excellence in rheumatoid arthritis in Latin America in which, under the coordination of a rheumatologist, a comprehensive care of patients with this pathology is established, in order to To obtain the best clinical results in a safety scenario for patients, improve the indicators of administration and management of the disease and obtain multiple data for research and to improve national and regional policies in this disease. The project explains and teaches what is a Center of Excellence in rheumatoid arthritis, its definitions and characteristics and how the concept can be applied in Latin America; Twenty-two opinion leaders from PANLAR member countries, through a Delphi process, participated in the definition of minimum standards of quality and of the three types of centers of excellence: STANDARD, OPTIMAL AND MODEL.
During this year's PANLAR congress in Panama City, a methodological proposal for the systematic and progressive implementation of the Centers of Excellence in rheumatoid arthritis will be established and presented.