Renewed hope emerges in RA battle

The prognosis of Rheumatoid Arthritis (RA) as a life-debilitating illness is changing, according to a new feature article in the January/February 2008 issue of WebMD Magazine.

Citing new drug treatments, remission rates, and anecdotal evidence, author Denise Mann highlights the progress being made on multiple fronts.

"The changes occurring in RA over the last decade or two have been nothing short of miraculous," Dr. James O'Dell, a rheumatologist at the University of Nebraska Medical Center in Omaha, tells Mann. "We have learned how to better diagnose RA early and how important it is to get our patients on disease-modifying anti-rheumatic drugs (DMARDs) earlier."

That earlier diagnosis is critical, because it leads to higher remission rates, according to O'Dell.

"In 40 percent of people we are getting there [achieving remission]," he told Mann. "And in another 40 percent we are getting very close."

Newer "biologic" drugs also contribute to higher remission rates. Mann explains biologics as a subset of DMARDs ("an umbrella term for drugs that can slow or halt the course of inflammatory conditions such as RA") that have hit the market within the last decade.

These can be used in conjunction with older, more established drugs like methotrexate -- though they work differently. "Unlike traditional DMARDs," Mann writes, "which have general targets and result in widespread suppression of the immune system, biologics hone in on a specific area of the immune system thought to be involved in RA inflammation."

Not only is it important to catch arthritis early to achieve remission -- but also to prevent long-term damage. As CreakyJoint's own Seth Ginsberg often illustrates at events around the country, if you imagine your body as a candle with your joints the wax -- arthritis is the flame. Once the candle is lit, and the wax begins to melt, you can never put the wax back to its original state.

"[For people] seen late in the disease, there may already be permanent damage," O'Dell tells Mann. "And then the only option is to surgically replace their joints. But if they come in early, in many cases we can control the disease to a level that it is a nuisance, not something that dramatically affects their life." That would be akin to shrinking the candle's flame, if not blowing it out altogether.

The negative aspects of these medical advances are still being studied. As the various DMARD drugs suppress the immune system (as Mann says, RA "happens when the immune system engages in friendly fire against its own joints"), the patient can be vulnerable to infections, such as tuberculosis. Another challenge Mann points out: "Some research has linked [the use of biologics] to skin cancer, including potentially fatal melanoma, as well as heart failure."

To read Denise Mann's full WebMD Magazine article, including the story of how 62-year-old arthritis warrior Donna Schwartz went from a wheelchair existence in New York to producing and directing comedies at a Delray Beach, Fla. theater, click on the link below:

Article References
RA of Hope: New treatments, more aggressive therapies, and earlier diagnosis are easing rheumatoid arthritis' grip on people's lives, site accessed on 02/22/08