skip to the content

RA is a chronic inflammatory disease which can lead to debilitating joint dysfunction and damage of multiple organ systems

Signs, symptioms and co-morbidities

Signs, Symptoms and Co-morbidities of RA

  • RA affects the small joints of the hands and feet, as well as larger joints throughout the body.
  • In a healthy joint, a delicate lining called the synovium covers the internal joint structures and tendons.1 It serves to provide a healthy environment for the joint while providing lubrication.
  • In RA, the synovium is attacked by activated immune cells, which proliferate, secrete inflammation-producing chemicals and express degradative enzymes, forming a joint-damaging tissue clinically referred to as the pannus.2
    • This digests the extracellular matrix (an important joint-stabilising tissue) and destroys the surrounding structure of the joint, leading to potentially irreversible cartilage degradation, joint damage and bone erosion.2,3
    • Joint pain, stiffness and swelling ensue, which can cause severe impairment in the movement of joints and result in significant disability.1

RA is associated with a wide range of extra-articular and systemic manifestations of disease that lead to further functional impairment and a reduction in life expectancy1,4

  • While joint pain, stiffness and inflammation are hallmarks of RA, the disease can affect virtually any area of the body, including the nervous system, the lungs, the vasculature and the heart.
    • Cardiovascular diseases, which evidence suggests are influenced by the systemic inflammatory response in RA,5 have been reported as the most common of the extra-articular and systemic manifestations of RA, reported in about 1 in 4 newly diagnosed patients.4
  • As the systemic effects of RA progress, patients have an increased risk of dying from urogenital, gastrointestinal, respiratory and cardiovascular diseases, infections and cancers compared with the general population.6

References:

  1. Smolen JS & Steiner G. Therapeutic strategies for rheumatoid arthritis. Nat Rev Drug Discov 2003; 2:473–488.
  2. Firestein GS. Evolving concepts of rheumatoid arthritis. Nature 2003; 423:356–361.
  3. Aletaha D, et al. Measuring function in rheumatoid arthritis: Identifying reversible and irreversible components. Arthritis Rheum 2006; 54:2784–2792.
  4. Hochberg MC, et al. The incidence and prevalence of extra-articular and systemic manifestations in a cohort of newly-diagnosed patients with rheumatoid arthritis between 1999 and 2006. Curr Med Res Opin 2008; 24:469–480.
  5. Sattar N, et al. Explaining how “high-grade” systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003; 108:2957–2963.
  6. Sihvonen S, et al. Death rates and causes of death in patients with rheumatoid arthritis: a population-based study. Scand J Rheumatol 2004; 33:221–227.