Facts on Rheumatoid Arthritis

What is arthritis?

Arthritis is a general term that refers to a disorder of one or more joints.(1)

What are the most common forms of arthritis and how are they different from each other?

There are more than 100 known types of arthritis, the most common being osteoarthritis (OA) and rheumatoid arthritis (RA).

In osteoarthritis (sometimes called degenerative arthritis) the changes occur in the cartilage, the smooth structure covering the ends of the bones. This becomes thin, rough and eventually wears away so that bone rubs against bone.2 Osteoarthritis usually affects the fingers and weight-bearing joints, including the knees, feet, hips and back.(3)

Rheumatoid arthritis (RA) is an auto-immune disease, that is, a disease where a person's immune system attacks his or her own body tissues. In RA the problem begins in the lining of the joint (synovium) which becomes inflamed. This produces swelling in the joint and causes secondary damage to the bone and cartilage in the joint.2 Rheumatoid arthritis often affects the same joints on both sides of the body. The hands, wrists, feet, knees, ankles, shoulders, neck, jaw and elbows can be affected.(3)

What are the symptoms of RA?

Tender, warm, swollen, painful and stiff joints are the main features of RA. Other signs and symptoms can include fatigue, interrupted sleep, weight loss, anaemia, nodules, ulcers, atrophic skin, muscle weakness, impaired joint function and inflammation of the heart, lungs, eyes, nerves, blood vessels and lymph glands.(1)

How may people have RA in Australia?

The 1999 Australian Institute of Health & Welfare publication 'The burden of disease and injury' puts the prevalance at 0.3% of the total population. Approximate incidence rates from the report calculated 30/100,000 in females and 10/100,000 in males, giving an overall incidence rate of 20/100,000 of population.(4)

What causes inflammation in RA?

Over recent years scientists have learned a lot about the way the inflammation occurs in the joints. One of the key proteins in this process is called Tumor Necrosis Factor alpha (TNF alpha). This is the protein that infliximab targets and blocks its action.

What effect does RA have on people's lives?

For many, daily joint pain is an inevitable consequence of RA. Some people also experience some degree of depression, anxiety, and feelings of helplessness. In some cases RA can interfere with a person's ability to carry out normal daily activities, or disrupt the joys and responsibilities of family life.

The onset of RA is most commonly between 25-50 at a time when people are active in the workplace.1 After 10 years, 50% of people initially in employment wih RA no longer work, most losing their jobs in the first 12 months after diagnosis.(5)

There are arthritis self-management programs that include medication, exercise and stress management that can help people cope with the pain and other effects of the disease and help them lead independent and productive lives.

Where can people with RA go for more information and support?

The Arthritis Foundation of Australia can be contacted via 1800 011 041 and their website, www.arthritisfoundation.com.au, is a useful resource with links to State Branches. The Branches are like support groups and can provide people with valuable education materials and meetings.

The Australian Rheumatology Association website, www.rheumatology.org.au, highlights many useful RA links as well as a State breakdown of their membership.

References
1. Access Economics Pty Ltd (2001), The prevalence, cost and disease burden of arthritis in Australia, prepared for The Arthritis Foundation of Australia.
2. The Arthritis Foundation of Australia, www.arthritisfoundation.com.au
3. The Arthritis Foundation, Arthritis Answers Booklet, Item No. 835-5400, www.arthritis.org
4. Mathers, C., Vos, T. and Stevenson, C. (1999) The burden of disease and injury in Australia, AIHW Cat. No. PHE17.
5. Markenson, JA. (1991), "Worldwide trends in socio-economic impact and long-term prognosis of rheumatoid arthritis", Sem Arthritis Rheumatism, 1991;21 (suppl1):4-12.

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