By Dr. W. Gifford Jones
January 18, 2005
For people free of pain it's hard to envision the problems suffered by those who have severe rheumatoid arthritis (RA). Those with joints so swollen and tender they're unable to do simple things like buttoning up a shirt, unable to walk down stairs unless they do so backwards holding railings with both hands. The psychological trauma when the condition gets steadily worse is also crippling. Now, a new drug, Humira, is restoring these patients to a normal life.
Many famous people have suffered from RA. Pierre-Auguste Renoir the famous 19th century painter developed RA in mid life. His hands became so crippled that his paint brush had to be wedged between his fingers. But he kept his sense of humour. He joked that he never finished a nude painting until he thought he could pinch it! Lucille Ball, revered as the Queen of Comedy, also suffered from this disease.
Unlike osteoarthritis, the wear and tear type of aging, rheumatoid arthritis is an inflammatory condition which attacks multiple joints, primarily the hands and feet. This eventually results in severe destruction of the joint causing disfigurement and loss of normal motion.
RA is not a rare disease. In Canada, over 300,000 people have been diagnosed with this trouble which strikes people of all ages including children. It's seen three times more often in women than men and is usually diagnosed between 25 and 50 years of age.
Studies show that RA shortens longevity by 12 years. A person 50 years of age diagnosed with RA, and another of the same age diagnosed with HIV, share the same life expectancy.
Typically people with RA experience "flare-ups", so called because of the intense heat generated by these attacks. During flare-ups there is progressive destruction of cartilage and bone in the joints followed by periods of remission.
How much RA progresses cannot be predicted in any given person. We know that between 5 percent and 20 percent of people with RA have a mild form and experience spontaneous disappearance of symptoms usually within the first two years. But 50 percent of these patients eventually have a recurrence. Others with severe RA are partially disabled within 12 years after the disease is diagnosed and 16 percent completely disabled.
This represents a huge economic burden for our country. Once RA begins 30 percent of people with RA are unable to work 10 years later, making it the number one reason for disability.
How to treat RA has taxed the brains of researchers for years. RA is thought to be an autoimmune disorder. What happens is that our white cells that normally combat inflammation become turncoat. Rather than firing their guns at the enemy they turn the guns on themselves. Now, researchers using molecular techniques, have developed "Humira" to stop this self-destructing process from happening.
Humira is what scientists call a "disease-modifying anti-rheumatic drug" (DMARD). The drug is administered by injection every two weeks and works fast. Patients often experience results within two weeks. The full effect may take up to two months but during this time it relieves pain, reduces the number of swollen tender joints, increases mobility, decreases fatigue and slows the rate of progression of RA.
There is no single test to quickly diagnose RA. So patients and doctors must have a high incidence of suspicion when there's a history of tender, swollen joints. But unfortunately one of the main problems of RA is that often months and years go by before the disease is diagnosed and precious time is lost in treating it.
Early diagnosis and treatment is important because rheumatoid arthritis can worsen very quickly in its early stages. Studies show that it can cause serious damage to the joints in just the first 24 months. So put time on your side and consult your doctor long before this happens to prevent joint destruction and early disability. Unlike Renoir you may not want to create 6,000 paintings. But you do want to be able to button up your shirt and not be forced to walk backwards down the stairs.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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