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New Advances in Rheumatoid Arthritis

May 17, 2011

Learn About Treatment Options at Washington Hospital Seminar

Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. An estimated 1.7 million people in the United States have the disease, according to the Arthritis Foundation, and about 70 percent of those are women.

"Rheumatoid arthritis can be very painful and debilitating," said Dr. Sabiha Rasheed, a local rheumatologist who is a member of the Washington Hospital staff. "Fortunately, there are treatment options available that can help to prevent joint damage and slow the progression of the disease."

She will present "New Advances in Rheumatoid Arthritis" on Monday, May 23, from 7 to 8 p.m. The free seminar will be held at the Conrad E. Anderson, M.D. Auditorium at 2500 Mowry Avenue (Washington West) in Fremont. You can register online at www.whhs.com or call (800) 963-7070 for more information.

Rasheed will provide an overview of rheumatoid arthritis. Like other autoimmune diseases, it occurs when the immune system mistakenly attacks tissues in the body. Rheumatoid arthritis can cause swelling, pain, and stiffness in the joints. The inflammation occurs in the joints and chronic inflammation can lead to the destruction of cartilage, bone, and ligaments, which can damage the joints and cause them to become deformed, according to Rasheed.

"This damage to the joints can occur early in the disease and then get worse as the disease progresses," she said. "That’s why it’s important to get an early diagnosis."

Researchers are not sure what causes rheumatoid arthritis. It can begin at any age, but most often affects people over the age of 40.

While the cause of rheumatoid arthritis is unknown, heredity appears to play a role, particularly in women, Rasheed said. About 80 percent of adults with the disease test positive for a certain antibody called rheumatoid factor, she added. Antibodies are proteins that are part of the immune response. They detect and destroy invaders like bacteria or viruses.

Preventing Joint Damage

Rasheed will talk about medications available today that can help to stop joint damage and prevent deformities. She will discuss two types: disease-modifying antirheumatic drugs called DMARDs and biologic agents.

DMARDs act on the immune system to slow the progression of the disease. These drugs have been around a long time and have been the standard course of treatment for people with rheumatoid arthritis, according to Rasheed. While there are a number of these types of medications available, Methotrexate is the most commonly used DMARD.

"DMARDs decrease pain and swelling, but they are not as effective at halting joint damage," she said. "The newer drugs are much more effective."

Biologic agents are the newest category of medications used to treat rheumatoid arthritis. They came onto the market about a decade ago and are now more widely prescribed, according to Rasheed.

"The drugs of interest are Enbrel, Humira, Remicade, Simponi, Orencia, and Cimzia," she said. "I will focus on those."

Each of these biologics blocks a specific step in the inflammation process. Rasheed will explain how they work.

"These newer biologics are becoming the medicine of choice for rheumatoid arthritis," she said. "Physicians are now prescribing them earlier on in the disease process because they are so effective at stopping joint damage and preventing deformities. They are also used in combination with standard DMARDs."

She said the drawback with biologic agents is they increase the risk for infection, so they can’t be prescribed for certain patients. They are not given to patients who are more prone to developing infections or have a recent history of cancer.

"For example, biologics aren’t recommended for the elderly, people who are bedridden, or someone who has had cancer in the last five years," she said. "But for those who can tolerate these newer medications, they can stop the joint damage caused by rheumatoid arthritis and improve their quality of life."

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