Rheumatoid arthritis takes high toll in unemployment, early death

July 2, 2012

In the realm of deadly and disabling diseases, conditions such as cancer and Alzheimer's seem to attract the most media attention. But there are others that take a similarly high toll, and rheumatoid arthritis is one of them, Mayo Clinic researchers say. It is a common cause of disability: 1 of every 5 rheumatoid arthritis patients is unable to work two years after diagnosis, and within five years, that rises to one-third. Life expectancy drops by up to five years, they write in the July issue of Mayo Clinic Proceedings in an article taking stock of current diagnosis and treatment approaches.

Rheumatoid arthritis patients also have a 50 percent higher and twice the danger of , Mayo researchers say. Much progress has been made in recognizing the importance of early diagnosis and prompt and , but gaps in understanding of the disease remain, say the authors, Mayo Clinic rheumatologists John Davis III, M.D., and Eric Matteson, M.D.

"There are many available now for management of , but the challenge for patients and their physicians is to decide on the best approach for initial management and then subsequent modification based on the response," Dr. Davis says. "In our article, we reveal our approach including algorithms for managing the disease that we believe will enhance the probability that patients will achieve remission, improved physical function, and optimal quality of life."

In rheumatoid arthritis, the immune system assaults tissue, causing swollen and tender joints and sometimes involving other organs. The top goal of treatment is to achieve remission, controlling the underlying inflammation, easing pain, improving quality of life and preserving patients' independence and ability to work and enjoy other pursuits. Long-term goals include preventing joint destruction and other complications such as heart disease and osteoporosis.

Dr. Davis and Dr. Matteson offer several tips and observations:

"It is very important to have rheumatoid arthritis properly diagnosed, and treatment started early on. Getting the disease under control leads to better outcomes for the patient, ability to continue working and taking care of one's self, less need for joint replacement surgery, and reduced risk of heart disease," Dr. Matteson says.

  • More than medication is needed to best manage rheumatoid arthritis. Educating patients about how to protect their joints and the importance of rest and offering them orthotics, splints and other helpful devices can substantially reduce pain and improve their ability to function. Cognitive behavioral therapy can make patients feel less helpless. Exercise programs that include aerobic exercise and strength training help achieve a leaner body; even modest weight loss can significantly reduce the burden on joints.
  • No treatment approach or guidelines can ever take into account every possibility; when a patient describes joint tenderness, fatigue and disease activity worse than the physician thinks they are, the physician should investigate the causes of symptoms. Non-inflammatory causes of pain such as osteoarthritis or regional musculoskeletal pain syndromes may be to blame.
  • Unanswered questions in rheumatoid arthritis include the relative benefits and harms of emphasizing initial treatment with prednisone; the effects of treatment on the risk of developing cardiovascular disease and other potentially deadly complications; and how to better predict how well treatments will work for specific patients and what the side effects will be.
"Our management approach is informed by current evidence and our clinical experience," Dr. Davis says. "We believe it is crucial that and their doctors thoroughly discuss the treatment options and decide on the management plan jointly in view of individual patient preferences, goals and values."

Explore further: Lower GI problems plague many with rheumatoid arthritis

Related Stories

Lower GI problems plague many with rheumatoid arthritis

April 3, 2012
Add lower gastrointestinal (GI) problems such as ulcers, bleeding and perforations to the list of serious complications facing many rheumatoid arthritis patients. They are at greater risk for GI problems and gastrointestinal-related ...

Standard heart disease risk tools underrate danger in rheumatoid arthritis

May 21, 2012
Heart disease risk assessment tools commonly used by physicians often underestimate the cardiovascular disease danger faced by rheumatoid arthritis patients, a Mayo Clinic study has found. Inflammation plays a key role in ...

Obesity epidemic fueling rise in rheumatoid arthritis among women

April 25, 2012
Obesity and the painful autoimmune disorder rheumatoid arthritis are each becoming more common, raising a logical question: Could one have something to do with the other? For women, it appears there is a link, Mayo Clinic ...

Ultrasounds spot heart disease early in rheumatoid arthritis patients

June 6, 2012
Special echocardiograms show promise for early detection of a potentially deadly complication in rheumatoid arthritis: heart disease, Mayo Clinic research shows. The findings were being presented at The European League Against ...

Young women with rheumatoid arthritis at more risk for broken bones

November 6, 2011
Women under 50 with rheumatoid arthritis are at greater risk of breaking bones than women without the condition, according to a Mayo Clinic study being presented at the American College of Rheumatology annual scientific ...

Recommended for you

Study shows prevalence of knee osteoarthritis has doubled since World War II

August 14, 2017
The average American today is twice as likely to be diagnosed with knee osteoarthritis than in the years before World War II, Harvard scientists say, but that increase can't be blamed on the reasons most might think.

Researchers find arthritis drug could treat blood cancer patients

August 3, 2017
Blood cancer sufferers could be treated with a simple arthritis drug, scientists at the University of Sheffield have discovered.

Fluid in the knee holds clues for why osteoarthritis is more common in females

June 26, 2017
Researchers have more evidence that males and females are different, this time in the fluid that helps protect the cartilage in their knee joints.

Biologics before triple therapy not cost effective for rheumatoid arthritis

May 29, 2017
Stepping up to biologic therapy when methotrexate monotherapy fails offers minimal incremental benefit over using a combination of drugs known as triple therapy, yet incurs large costs for treating rheumatoid arthritis (RA). ...

Drug for refractory psoriatic arthritis shows promise in clinical trial

May 24, 2017
In a pivotal phase-3 clinical trial led by a Stanford University School of Medicine investigator, patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced ...

Cross-species links identified for osteoarthritis

May 17, 2017
New research from the University of Liverpool, published today in the journal npj Systems Biology and Applications, has identified 'cell messages' that could help identify the early stages of osteoarthritis (OA).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.