Signs of Rheumatoid Arthritis Can Show Up Long Before Diagnosis

Signs of Rheumatoid Arthritis Can Show Up Long Before Diagnosis

FRIDAY, May 10, 2019 (HealthDay News) — Difficulties with daily activities such as dressing, walking and eating can be seen in rheumatoid arthritis patients a year or two before they’re diagnosed, a new study shows.

“This is a new finding, and a finding that is quite intriguing,” said lead author Dr. Elena Myasoedova, a rheumatologist at the Mayo Clinic in Rochester, Minn.

“It may reflect an accumulation of symptoms between the time of first onset and the time required for providers to actually diagnose patients,” she said in a Mayo news release.

The study also found that chronic increased levels of difficulty with daily activities (functional disability) continued even after patients were diagnosed with rheumatoid arthritis and began treatment.

That may be due to a number of factors, including increasing physical and mental pain, use of treatments such as glucocorticoids and antidepressants, and anticipation of relief from symptoms, she added.

For the study, the researchers looked at 586 rheumatoid arthritis patients and 531 people without the disease in the Rochester Epidemiology Project database of medical records.

The rate of functional disability was more than two times higher among rheumatoid arthritis patients than in those without rheumatoid arthritis. In most age groups, rheumatoid arthritis patients had a 15% or higher rate of functional disability than those without the disease.

The findings show the importance of early treatment for rheumatoid arthritis patients, according to Myasoedova.

“Alerting your health care provider to difficulties in daily living can assure that patients receive the help they need,” she said.

About 1.5 million Americans have been diagnosed with rheumatoid arthritis, an autoimmune disease that most often affects the joints but can also impact other parts of the body. Rheumatoid arthritis is one of the most common chronic conditions associated with functional disability in the United States, and has a significant impact on well-being and quality of life.

Symptoms can include joint pain or swelling, but 40% of patients have symptoms that don’t involve the joints, such as fatigue, fever and loss of appetite.

The study will be published in June in the journal Mayo Clinic Proceedings.

More information

The American Academy of Family Physicians has more on rheumatoid arthritis.

SOURCE: Mayo Clinic, news release, May 1, 2019Copyright ©2017 HealthDay. All rights reserved.

Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Obesity may accelerate and amplify the crippling symptoms of rheumatoid arthritis, new research suggests.

Conversely, the researchers also found that unexplained weight loss might also signal problems for these patients, because it could mean that they’re at greater risk for disability.

“While patients and rheumatologists may be focused mostly on disease activity, we should also consider this common condition [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” said study author Dr. Joshua Baker.

“In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability,” he added. Baker is an assistant professor of medicine at the University of Pennsylvania’s Perelman School of Medicine.

Rheumatoid arthritis is an autoimmune condition. It develops when immune cells that normally fight germs attack the lining of the joints, or cartilage. This causes the joints to swell and the surrounding bones, ligaments and muscles to gradually erode. Rheumatoid arthritis worsens over time, often leading to disability.

For the study, Baker and his colleagues looked at the effects of obesity on the progression of rheumatoid arthritis in just over 25,000 people with the disease.

The investigators found that the disease advanced more quickly among those who were very obese. This was true regardless of the level of inflammation in their joints.

In addition, people who were thin but lost weight without trying also became disabled more quickly.

The study was published April 30 in the journal Arthritis Care & Research.

“So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy,” Baker said in a journal news release.”

“However, when we see that someone is losing weight without trying, it’s probably a poor prognostic sign, especially if they are already thin,” he added.

Although the study could not prove a cause-and-effect link, the researchers suggested that new treatments and strategies to help people maintain a healthy weight might help prevent disability among people with rheumatoid arthritis.

And, Baker’s team noted, the findings could help doctors recognize signs of frailty among their rheumatoid arthritis patients who may benefit from strength training and physical therapy.

More information

The Arthritis Foundation has more about obesity and rheumatoid arthritis.

SOURCE: Arthritis Care & Research, news release, April 30, 2018

Certain Jobs Linked to Raised Risk of Rheumatoid Arthritis

Certain Jobs Linked to Raised Risk of Rheumatoid Arthritis

Rheumatoid arthritis, a painful disease in which a person’s immune system attacks the joints, appears to be more common among people in certain types of jobs, researchers suggest.

The findings “indicate that work-related factors, such as airborne harmful exposures, may contribute to disease development,” study author Anna Ilar said. She is a doctoral student in epidemiology at the Karolinska Institute in Stockholm.

The study looked at more than 3,500 people in Sweden with rheumatoid arthritis, and nearly 5,600 people without the disease.

Among men, those in manufacturing jobs had a higher risk of rheumatoid arthritis than those in the professional, administrative and technical sectors, the findings showed. The risk was twice as high for electrical and electronics workers, and three times higher for bricklayers and concrete workers.

Among women, assistant nurses and attendants had a slightly higher risk, but women in manufacturing jobs did not. The researchers suspect that’s because fewer women than men work in manufacturing.

More study is needed to zero in on the exposures that may be involved, Ilar noted. Potential culprits include silica, asbestos, organic solvents and engine exhaust.

The report was published online Aug. 10 in the journal Arthritis Care & Research.

“It is important that findings on preventable risk factors are spread to employees, employers, and decision-makers in order to prevent disease by reducing or eliminating known risk factors,” Ilar said in a journal news release.

The researchers said they accounted for lifestyle factors associated with rheumatoid arthritis, such as body fat, smoking, alcohol use and education level. However, while the study found an association between certain occupations and rheumatoid arthritis risk, it didn’t prove a cause-and-effect relationship.

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