When you work on the Verrazano-Narrows, one of the biggest suspension bridges in the world, the cold temperatures and heavy lifting can really take a toll on your body. Construction worker John Melendez thought the pain and swelling he was experiencing in his hands, arms, and legs were just side effects of his job. Eventually, the pain became so severe that the 52-year-old Staten Island resident was unable to work at all. “My fingers were so swollen that I couldn’t bend them,” Melendez recalls. “I couldn’t even walk.”
When he finally went to see Jonathan Samuels, MD, an attending rheumatologist at New York University’s Langone Medical Center, Melendez was in so much pain that he had to be practically carried into the office. Tests revealed that he had rheumatoid arthritis or RA. RA is a degenerative autoimmune disease that attacks the joints. Melendez immediately thought of his mother, who also has RA and now lives in a nursing home. He worried that he would share her fate.
After a half-dozen pint-sized robots organize genetic material onto plates
and feed it into computers, Peter K. Gregersen, MD, painstakingly mines the
data, hoping to discover the unique genes that make some people more
susceptible to rheumatoid arthritis (RA).
Gregersen, head of the Feinstein Institute’s Robert S. Boas Center for
Genomics and Human Genetics in Manhasset, N.Y., and his team are edging closer
to solving the puzzle. They recently announced the discovery of two new genes
Had he been diagnosed 20 or 30 years ago, that might have been the case. People with severe rheumatoid arthritis once had to look forward to a lifetime of chronic pain and disability. But today’s treatments have dramatically improved the outlook. “With the new medications, we’re able to stop the disease process,” Samuels says.
Disease-Modifying Medications for Severe RA
In the past, most patients with rheumatoid arthritis took pain relievers to alleviate their symptoms. But the drugs did nothing to slow the progressive joint damage that occurs with chronic RA. Today, patients are diagnosed earlier and treated more aggressively. And the medications used can actually change the course of their disease and reverse joint damage. “The earlier you catch somebody and the earlier you start effective therapy, the more likely you are to get them into remission,” says Eric Ruderman, MD. Ruderman is associate professor of medicine at the Northwestern University Feinberg School of Medicine. He’s also an attending physician at Northwestern Memorial Hospital. “We are becoming more and more aggressive in the way we treat people,” he says. “So the goal really is remission.”