Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.

Prognosis

The course of the disease varies greatly from patient to patient. Some patients have mild short-term symptoms, but in most the disease is progressive for life.

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Disability

• Daily living activities are impaired in most patients.
• After 5 years of disease, approximately 33% of patients will not be working
• After 10 years, approximately half will have substantial functional disability.

Prognostic factors

• Poor prognostic factors include persistent synovitis, early erosive disease, extra-articular findings (including subcutaneous rheumatoid nodules), positive serum RF findings, family history of RA, male sex, advanced age, poor functional status, socioeconomic factors, elevated acute phase response (erythrocyte sedimentation rate , C-reactive protein ), and increased clinical severity.

Mortality

• Life expectancy for patients with RA is shortened by 5-10 years, although those who respond to therapy may have lower mortality rates.