Rheumatoid Arthritis
Rheumatoid Arthritis Objectives: 1. 2. Describe common locations, signs, symptoms, and onset of rheumatoid arthritis (RA). 3. Given clinical characteristics, differentiate between RA and osteoarthritis. 4. Describe extraarticular manifestations of RA and recommend preventative measures. 5. List laboratory and radiology tests useful in evaluating and/or diagnosing RA. 6. Describe pharmacological and non-pharmacological approaches to treating RA. 7. Counsel on indication, SE, CI, MOA, black box warnings, monitoring, drug interactions, dose, and special precautions for pharmacological products used in managing osteoarthritis.
Introduction: * Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder characterized by potentially deforming symmetric polyarthritis and a wide spectrum of extra-articular manifestations. * The exact cause of RA is unknown.
Epidemiology: * The prevalence of RA is estimated to be about 1% worldwide. * It is 2 to 3 times more common in women than in men * Disease is usually more severe in men * Onset typically occurs between the 3rd and 4th decades of life * Prevalence increases with age up to the 7th decade * In the US, RA affects as many as 2 million people.
Pathophysiology * The inflammatory process leading to RA is believed to begin with abnormal propagation and activation of immune cells (T-cells, B-cells, and Macrophages). * It is unknown what initiates this process of abnormal propagation. * Immune cells promote the secretion of cytokines and other mediators (TNF-α, IL1, and IL6) which activate additional macrophages and rheumatoid arthritis synovial fibroblasts (RASFs), a more aggressive phenotype of synovial fibroblasts than found in non-RA patients. * Activated macrophages and RASFs release additional pro-inflammatory cytokines and mediators of vascular growth (VEGF). * VEGF cells promote
Introduction: * Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder characterized by potentially deforming symmetric polyarthritis and a wide spectrum of extra-articular manifestations. * The exact cause of RA is unknown.
Epidemiology: * The prevalence of RA is estimated to be about 1% worldwide. * It is 2 to 3 times more common in women than in men * Disease is usually more severe in men * Onset typically occurs between the 3rd and 4th decades of life * Prevalence increases with age up to the 7th decade * In the US, RA affects as many as 2 million people.
Pathophysiology * The inflammatory process leading to RA is believed to begin with abnormal propagation and activation of immune cells (T-cells, B-cells, and Macrophages). * It is unknown what initiates this process of abnormal propagation. * Immune cells promote the secretion of cytokines and other mediators (TNF-α, IL1, and IL6) which activate additional macrophages and rheumatoid arthritis synovial fibroblasts (RASFs), a more aggressive phenotype of synovial fibroblasts than found in non-RA patients. * Activated macrophages and RASFs release additional pro-inflammatory cytokines and mediators of vascular growth (VEGF). * VEGF cells promote