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Expert Answers to Top Questions About Rheumatoid Arthritis

WebMD the Magazine – Feature     By Denise Mann Reviewed by Michael W. Smith, MD

Whether you have just been diagnosed with rheumatoid arthritis (RA) or have been living with this autoimmune disease for years, you no doubt have many questions and concerns. To help you get up to speed on the best ways to manage your RA today and for years to come, we took your top questions to rheumatologist Linda A. Russell, MD, an assistant professor of medicine at Weill Medical College of Cornell University and an assistant attending physician at the Hospital for Special Surgery in New York City.

What causes RA?

The precise cause of RA is not yet known. Some research suggests that genes play a role. Other potential culprits include environmental factors such as smoking, and also hormones, since women are two to three times more likely to develop RA than men. Scientists have long suspected infectious agents such as viruses and bacteria may play a role. Either a single factor or a combination prompts the immune system to misfire, attacking its own joints and resulting in pain and inflammation.

How is RA diagnosed today?

We take a thorough history, perform a physical exam, and then evaluate blood work and X-rays. Currently two acceptable blood tests help us make an RA diagnosis. We test for the presence of rheumatoid factor [RF] and anti-CCP [anti-cyclic citrullinated peptide antibody]. [But] these blood tests are not definitive. Anywhere from 10% to 30% of people with RA can be RF-negative or anti-CCP-negative.

When should I start seeing the effects of my new medication?

If you don’t start feeling better within three months, there is probably reason to change or tweak your medication regimen. Feeling better means having more energy, less morning stiffness, less joint pain, and less swelling.

When should I get a second opinion about my treatment?

Get one if you feel that your RA is active and your current doctor doesn’t have anything else to offer or if you are concerned about the side effects of your current medication regimen.

Is there a cure for RA?

Not yet—but many effective medications can control inflammation and help prevent lasting joint damage. In the last 10 years, we have seen a whole new class of drugs called biologics, which exert a greater control over inflammation and have changed the course of RA. These drugs mimic the effects of substances naturally made by the body’s own immune system. The biologics target very specific inflammatory proteins called cytokines such as tumor necrosis factor-alpha. Even with no cure, 10% of people with RA will go into complete remission and be able to stop all of their medications indefinitely.

Will RA affect my chances of getting pregnant and having a healthy baby?

Women with RA do not appear to have decreased fertility, and they often go into remission during pregnancy. Women may have a flare within six to eight weeks of giving birth. Breastfeeding might be problematic because if a woman has a flare, she will need to resume taking her medications, and RA medications can’t be taken while breastfeeding because the drugs can get into the milk supply.

Are my children at risk for developing RA if I have it?

They are at a slightly increased risk of developing RA or another autoimmune disease. [But] we don’t recommend that people with no symptoms have any type of screening test at this point.

Can I live a long life with RA?

Yes. If you have active RA, it’s important to treat the underlying inflammation. This will have positive effects on your quality of life and your life expectancy. People with RA seem to have a greater chance of having heart disease … but treating the inflammation can help reduce that risk. Managing the traditional risk factors for heart disease helps, too — maintaining an appropriate weight and controlling blood pressure and cholesterol levels if they are elevated.


October 29, 2009 - Posted by | 1

1 Comment »

  1. Ah!!! at last I found what I was looking for. Somtimes it takes so much effort to find even tiny useful piece of information.
    Nice post. Thanks

    Comment by Car Insurance Guy | November 11, 2009 | Reply

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