Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic inflammatory condition that can impact many different parts of the body, such as the skin, lungs, heart and blood vessels. In some cases, this condition can also lead to significant damage to other systems.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly targets joints, tendons or other tissues in your body.

Unlike the wear-and-tear type of damage caused by osteoarthritis, rheumatoid arthritis affects joints from the inside. This leads to a painful swelling and, at high doses, bone erosion and joint deformity.

The type of inflammation present in rheumatoid arthritis has the potential to damage other parts of the body. However, new types of medication have made treatment options much more reliable. Severe rheumatoid arthritis can still give rise to physical disabilities, but they are less likely now.

 

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis signs are not always clear, but they may include:

  • Joints can become swollen and tender. Pain can also develop in these areas.

  • Joint stiffness that is usually worst in the mornings and after periods of inactivity.

  • Symptoms of fatigue, fever and loss of appetite

Early-onset arthritis can affect joints in your fingers and toes. It usually affects the joints that attach these to the rest of your body – especially in your hands and feet.

Symptoms often spread to your wrists, knees, ankles, elbows, hips and shoulders when the disease progresses. Typically symptoms only occur in one joint on each side of your body.

About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. Areas that may be affected include:

  • Skin

  • Lungs

  • Eyes

  • Kidneys

  • Heart

  • Nerve tissue

  • Salivary glands

  • Blood vessels

  • Bone marrow

Rheumatoid arthritis can come in many different forms and can vary in severity, with periods of increased disease activity (flares) alternating with periods where symptoms are less severe. It is important to always ask your doctor what the best treatment option it for you. As time progresses, someone diagnosed with rheumatoid arthritis may notice that their joints can change shape and get displaced.

When to see a doctor

Please make an appointment with your doctor if you are experiencing persistent pain and swelling in your joints.

Causes of Rheumatoid Arthritis

Rheumatoid arthritis is a type of autoimmune disease. In normal cases, the immune system’s main role is to protect the body from infections. In rheumatoid arthritis, the immune system attacks healthy tissue in your joints and can cause it to malfunction in other ways.

Medicine has long been unable to pinpoint what actually causes rheumatoid arthritis, although it seems to be hereditary. Genetics by themselves are not enough to give you RA, but they can play a part in influencing your susceptibility to environmental factors, such as an infection with Epstein-Barr virus.

Risk Factors of Rheumatoid Arthritis

The risk of developing rheumatoid arthritis may be increased based on the following factors:

  • Your sex. More women are diagnosed with rheumatoid arthritis relative to men.

  • Age. Rheumatoid Arthritis can happen at any age, usually starting in middle age.

  • Family history. If one of your relatives has rheumatoid arthritis, you may be more susceptible to developing it.

  • Smoking. Smoking can make you more likely to develop rheumatoid arthritis, especially if you’re predisposed to the disease. It also makes it more severe in most cases.

  • Excess weight. People who are overweight appear to be at a higher risk of developing rheumatoid arthritis.

Complications of Rheumatoid Arthritis

Rheumatoid arthritis increases your risk of developing:

  • Osteoporosis. One of the possible side effects of RA is osteoporosis–which can lead to more fractures and makes it difficult for you to maintain a healthy bone mass.

  • Rheumatoid nodules. These firm bumps of tissue can form in a number of places, including the heart and lungs. They may be caused by pressure from the elbows but can also happen elsewhere in the body.

  • Dry eyes and mouth. People with rheumatoid arthritis are more likely to develop Sjogren’s syndrome, which will decrease the amount of saliva in the mouth & eyes.

  • Infections. The condition and many of the medications used to control it can weaken your immune system, raising the risk of a range of infections. Protect yourself with vaccines – these will help prevent diseases such as influenza, pneumonia, shingles and COVID-19.

  • Abnormal body composition. People with rheumatoid arthritis often have more fat than lean muscle. People who focus on weight loss after diagnosis could be unknowingly contributing to further joint damage due to the higher proportion of fat.

  • Carpal tunnel syndrome. If you are suffering from rheumatoid arthritis, you might experience pain or twisting in your wrists. These can lead to compression in your median nerve. The median nerve is the one that provides motor control to most of your hand and fingers.

  • Heart problems. Individuals that have rheumatoid arthritis increased the risk of getting hardened and blocked arteries that are embedded within the heart. These risks increase alongside any form of inflammation.

  • Lung disease. People with rheumatoid arthritis have a higher chance of developing inflammation and scarring in their lungs. This can make it hard to breathe and could lead to respiratory failure.

  • Lymphoma. Rheumatoid arthritis increases the risk of lymphoma. Lymphoma is a group of blood cancers that develop in the lymph system.

Rheumatoid Arthritis Treatment

There are many different treatments available for arthritis, ranging from medications to surgery to physical therapy. It’s important to have a plan in place before you start any kind of treatment so you know what steps to take if one option doesn’t work or starts causing side effects.

The primary goals for those with rheumatoid arthritis (RA) are to control inflammation as well as ease pain and reduce disability.

Treatment often includes medications, occupational therapy, or physical therapy. Some people will need surgery to correct the damage to their joints. Early treatment is key to good recovery. And fortunately, today’s treatments can not only stop the damage but also slow it down for many people.

Drugs for Rheumatoid Arthritis

NSAIDs

Your doctor may recommend some form of nonsteroidal anti-inflammatory drug (NSAID) as part of your treatment plan for rheumatoid arthritis. These medications can reduce pain & inflammation but do not have a slowing effect on RA. As a result, you will also need to take additional drugs to prevent further joint damage.

Many over-the-counter pain relievers come in the form of pills or tablets. They include ibuprofen and naproxen, among others. If you have RA, a prescription medication might be a better choice, such as celecoxib (Celebrex), since it offers a higher dose with longer-lasting effects and requires fewer doses throughout the day.

Prescription NSAIDs carry warnings about the increased risk of heart attack and stroke. They can also raise blood pressure and cause stomach problems, ulcers, or bleeding.

DMARDs

One type of drug for RA limits the immune system to help slow the progression of RA or keep it from getting worse. The drugs are called disease-modifying antirheumatic drugs, which stands for DMARDS.

Your doctor will typically prescribe methotrexate (Trexall) as the first DMARD for rheumatoid arthritis. If you do not see relief, your doctor may prescribe one of several other types such as hydroxychloroquine (Plaquenil), leflunomide (Arava), or sulfasalazin.

It can take a few weeks or months for DMARDs to be effective and they may take longer to work for full effects.

A weakened immune system can lead to many problems, including infections and other side effects. Certain medicines can also cause birth defects. If you’re planning to start a family, make sure to ask your doctor about the risks

DMARDs are medications, which include Methotrexate, that have been shown to make improvements in severe RA. They are often used to try help save the health of your joints.

Biologics

When treatments such as methotrexate and other DMARDs don’t provide relief from RA symptoms and inflammation, biologics can be used. These are genetically engineered proteins. A number of immune system-modifying drugs prevent this inflammation from happening. They work quickly to relieve joint pain and swelling.

Many drugs are anti-inflammatories, meaning they block TNF production. Drugs can also be targeted towards other chemicals in the body.

There are a number of different types of biologics that target different parts of the immune system. They include:

  • Abatacept (Orencia)

  • Adalimumab (Humira)

  • Adalimumab-atto (Amjevita), a biosimilar to Humira

  • Anakinra (Kineret)

  • Baricitinib (Olumiant)

  • Certolizumab (Cimzia)

  • Etanercept (Enbrel)

  • Etanercept-szzs (Erelzi), a biosimilar to Enbrel

  • Golimumab (Simponi, Simponi Aria)

  • Infliximab (Remicade)

  • Infliximab-dyyb (Inflectra), a biosimilar to Remicade

  • Rituximab (Rituxan)

  • Sarilumab (Kevzara)

  • Tocilizumab (Actemra)

You might take biologics by injection at home, in a hospital, or as a pill.

Biologics cause a slowdown in your immune system so your body is more likely to get sick with infections. It may also bring certain past infections back or give you a flare up in an existing infection, such as with tuberculosis. While IV medication may be the best option for some, there are many risks to these treatments. You might experience severe reactions like chest pain or trouble breathing. These come with other risks like hives and infection. Talk with your doctor about which treatment is right for you, but be aware of the side effects that each drug will trigger.

Steroids

For chronic RA, steroids may be prescribed at the first signs of pain or stiffness. You may need to take them for a while to control pain and inflammation. However, they are unlikely to completely clear up joint pain without any other treatments. Hydrocortisone, methylprednisolone, and prednisone are all common corticosteroids.

One can take steroids as either a shot or pill, but pills are safer for one’s bones and tissue. It is possible to get shots, but they cannot be taken more than once every 3-4 months.

Steroids can cause weight gain and bone loss, which can worsen osteoporosis. They can also affect your blood pressure, make diabetes worse, and make you more prone to infections. Generally, taking smaller doses for a shorter time will result in fewer side effects.

Combination Therapy

Taking more than one medication can greatly help you with your mobility. This will make it easier for you to move and lower the risk of joint damage caused by RA.

Methotrexate, as well as hydroxychloroquine, leflunomide, or sulfasalazine drugs are often prescribed with other medications. Biologic agents are also used in combination therapy.

Taking more than one medication won’t cure the damage you already have, and it’s not a substitute for other treatments. But it can prevent any worsening of your arthritis and help avoid some of the side-effects that come with this condition, like heart attack or stroke.

Surgery for Rheumatoid Arthritis

Joint pain and inflammation can be very difficult for some people to manage. If the pain and inflammation becomes too bad, surgery options may be available. Hip and knee replacement surgery is common as those are the joints that experience most damage or wear and tear with time. Most people wait until they turn 50 years old to get artificial knees or hips because the joints wear down and need to be replaced after 15-20 years.

Some joints, such as the ankles, do not respond well to artificial replacement and tend to do better with an operation called joint fusion.

Physical and Occupational Therapy

Rheumatoid arthritis treatment plans require a lot of attention and involve many components to improve the daily life of someone living with this condition. Physical therapy, occupational therapy and more can be an integral part of such a treatment plan

Some of the many things physical therapists do for their clients include creating an exercise plan, giving therapeutic massage and / or heat and ice treatment to relieve pain, and encouraging you to stick to your goals.

Occupational therapists help take care of day-to-day tasks and show you how to do them more easily. One task they carry out is checking if a gadget would be useful for you.

How Cognitive Therapy Can Help

Rheumatoid arthritis can be hard to live with, because of the pain. In order to overcome these difficulties, doctors may promote “cognitive therapy”. This is a way of regulating and overcoming the pain.

Our aim is to enhance your mental well-being while you develop a variety of strategies for relaxation, stress management, and self-control. This may involve establishing regular routines and using activities such as imagery, relaxation exercises, avoidance, and creative problem solving.

There is hope for Rheumatoid Arthritis patients. Contact us at 734-404-6065 to find out how Superior Compounding Pharmacy can help.

How Can Infusion Therapy Work For Rheumatoid Arthritis?

In some cases, patients with moderate to severe rheumatoid arthritis have a difficult time taking oral medications or they simply don’t work. When this occurs, your doctor might prescribe infusion therapy of intravenous medications, including Remicade and Orencia. One of the benefits of other methods is that drugs are delivered directly into your bloodstream, which can produce faster and more effective results. Some further advantages include:

  • Provide relief from swelling, pain, and stiffness.

  • Allowing you to perform daily tasks with less difficulty

  • Preventing additional joint damage

  • Slowing the progression of bone damage

  • Reducing fatigue

Infusion therapy for rheumatoid arthritis can provide relief from pain & other symptoms anywhere between 6 months to a year. The length of each session also depends on the severity of the illness, as well as the type of medication being administered.

Are There Any Side Effects of Infusion Therapy?

Yes, as with any type of treatment it’s possible for a person to feel side effects – such as feeling dizzy, shivering from the flu-like symptoms, fever at the site of infection,etc. In order to reduce the likelihood of side effects it’s important to tell your doctor about any previous reactions to medicines or painkillers. Mention all medications you’re taking currently. Your healthcare provider will be able to let you know more details about potential side effects related to these, as well as your physical condition at Infusion Therapy.

What To Expect During Infusion Therapy

Here, we will administer your medication by injecting a needle connected to a tube. This will be connected to an IV bag with the solution. Once attached to your arm, the fluid will slowly flow into your vein.

Each session can take up to several hours. At Superior Compounding, our staff is fully dedicated to your experience and will make sure that you are as comfortable as possible during treatments. You can also bring a book or magazine depending on the treatment, and receive infusions sitting in a reclining chair. We also offer blankets, beverages like coffee, tea or cocoa, and the opportunity to watch a movie or listen to music. You’ll always be in the care of either a doctor or nurse practitioner while you’re here.

If Your Doctor Has Recommended IV Therapy, Let Superior Compounding Help You

At Superior Compounding, we provide medically-prescribed infusion therapy to patients with chronic conditions in a friendly and welcoming environment. Our team of healthcare professionals will do everything they can to make this experience as comfortable as possible. Before starting treatment, it is important to be fully informed of all risks. We always make sure our patients are aware of these before they start any forms of treatment. We also have a pharmacist on-site if they’re looking for more information.

If you would like to refer a patient to us or want to inquire about our treatments, please do not hesitate to call us at 734-404-6065.