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RA of Hope

New treatments, more aggressive therapies, and earlier diagnosis are easing rheumatoid arthritis’ grip on people’s lives.
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Biologics: Boosting Rheumatoid Arthritis Treatment

Biologics are partly the reason. These drugs, on the market now for about 10 years, mimic the effects of substances naturally made by the body’s own immune system. Unlike traditional DMARDs, 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.

Specifically, biologics target inflammation-causing proteins called cytokines. These proteins are responsible for the inflammation causing RA, and biologic agents work to block them, calming the inflammation. While this class of drugs can be very effective, biologics also have their share of risks, namely increased risk of infection, such as tuberculosis. These drugs suppress the immune system and, as a result, a person is more prone to develop potentially serious infections. Some research has linked their use to skin cancer, including potentially fatal melanoma, as well as heart failure.

Despite these risks, doctors are prescribing “combinations of traditional DMARDs and biologics early on as a way to put patients into remission,” says John H. Klippel, MD, the president and CEO of the Arthritis Foundation, based in Atlanta.

Rheumatoid Arthritis: Early Diagnosis Helps

The sooner patients are diagnosed with RA, the more likely they are to go into remission with proper treatment, especially since RA can affect people years before they develop the first symptom. “The body starts changing immunologically an average of five years before you even get a symptom,” O’Dell says.

“[For people] seen late in the disease, there may already be permanent damage, 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.”

In the future, doctors hope to be able to diagnose RA before symptoms kick in, says Klippel. For now, take charge of your care if you do have RA. “Do not accept somebody telling you this is a disease that you just have to live with. You should not accept the outlook that you will end up in a wheelchair,” adds O’Dell.

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