Rheumatoid Arthritis

 

Rheumatoid arthritis (RA) is the most common form of chronic inflammatory polyarthritis. RA occurs worldwide and is more common in women than men. Approximately 23 million people (16.5 million women and 6.5 million men) suffered from RA in 2002. There seem to be geographical differences in RA occurrence, with prevalence estimates of 0.5 to 1.0% in North America and in northern Europe, but lower occurrence in southern Europe and some developing countries. Knowledge about RA incidence is limited, but several Scandinavian countries have reported annual incidence rates of 24-36 cases/100 000 person-years.

 

The aetiology of RA is almost unknown, but it is evident that both genes and environment are involved in disease development, as seen from both concordance data in twins and from a number of epidemiological and genetic studies. While knowledge about the contribution of genetics is rapidly increasing, there is still a lack of data on environmental factors that may cause RA.

 

Smoking is the main environmental factor that has consistently been related to an increased risk of RA. Smoking during a long time period yields the highest risk. Some genes suggest an increased risk of developing RA, but above all it is an interaction between specific environmental factors and certain genes that increases the risk of RA.

 

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease, affecting the joints in a symmetrical pattern. An untreated disease causes severe functional disability and permanent joint destruction.

 

In 1859 the term rheumatoid arthritis was introduced by Garrod and a set of criteria for the disease was developed by the American College of Rheumatology (ACR) in 1958. These criteria, revised in 1987, describe a syndrome characterized by chronic inflammation mainly in many joints (polyarthritis) including joints of the hands and feet.

 

Until some decades ago there was a lack of effective treatment against rheumatoid arthritis. Many patients experienced devastating disability. In recent years, new treatments have shown an impressive ability to slow down disease progression, prevent joint destruction and improve the health status of patients. The treatments are effective in the early stage of the disease and therefore a rapid referral from primary care is crucial to prevent further joint damage and disability.