Carla Guillory was in her 30s -- enjoying life, raising her kids -- when the first symptoms began. "We'd been hiking on vacation, and I thought I had bruised my foot, but it didn't seem to get better. Then my hands started aching," she remembers.
Right away, doctors suspected she had rheumatoid arthritis. Guillory was tenacious about finding the right doctor -- one who would treat her aggressively. She knew she had to tackle this thing head-on, she says. And that she did -- with disease-modifying drugs that helped curb the damaging inflammation at her joints.
Rheumatoid arthritis (RA) is a painful inflammatory disease that causes swelling, stiffness, joint destruction, and deformity. This autoimmune disease has an effect on the cells that coat and lubricate joints (synovial tissue).
Although osteoarthritis (the "wear and tear" arthritis") may affect one joint, such as hand arthritis or finger arthritis, rheumatoid arthritis usually happens symmetrically. For instance, RA may affect both wrists, both hands, both knees, and both ankles and feet.
That aggressive treatment, and getting it early, has made all the difference, says Guillory. "I have some deformity in my hands, but not a whole lot. It's nothing like other people I've met."
The Changing Picture of Rheumatoid Arthritis
Twenty years ago, the picture for most patients was very different. "A person in the fairly young part of life would get this disease, and within five years they would be deformed and disabled. About half the people with RA had to quit working within 10 years," says Stephen Lindsey, MD, chairman of rheumatology at the Ochsner Clinical Foundation in Baton Rouge, La.
More than two million Americans suffer from rheumatoid arthritis, also known as RA. About 75% of them are women, according to the American College of Rheumatology. While RA can develop at any age, it often begins between ages 30 and 50. Pain, stiffness, swelling, and limited motion and function of joints -- especially hand and foot joints -- are the primary symptoms.
Today, doctors are better able better to diagnose the disease, determine how advanced it is - and how best to treat it, says Lindsey. New research has revealed more about the disease itself.
Rheumatoid arthritis is an autoimmune disease, which means that the body mistakenly identifies certain cells as foreign and attacks them -- triggering the inflammation that damages healthy joints. Exactly what sparks this malfunction remains unclear, but research has led to important new treatments.
Some remarkable drugs have emerged to specifically short-circuit the immune system malfunction, says Lindsey, who has treated Guillory for the past eight years. "The last decade's been amazing. It used to be that we could treat the pain but not the disability. That's dramatically different now. The key is early diagnosis, then aggressive treatment with the right medicine."
Newer, Better Drugs for Rheumatoid Arthritis
To protect joints from damage, doctors turn to disease-modifying antirheumatic drugs (DMARDs). These include several drugs used in the 1960s and 1970s to treat other diseases -- and were discovered to also work with rheumatoid arthritis.
For example, methotrexate, a drug that Guillory took early on, was first used as a form of cancer chemotherapy. It's still considered an important medication for slowing RA, although it is prescribed at lower doses than used for cancer treatment, Lindsey explains. "The side effects are more acceptable for methotrexate than with other cancer drugs," he tells WebMD.