Comprehensive Review on Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory, systemic, progressive, autoimmune disease in which the body’s immune system whose major role is to protect the health by attacking foreign bacteria and viruses are mistakenly, attacking the joints resulting in thickened synovium, pannus formation & destruction of bone, cartilage. Many complications can follow such as permanent joint damage requiring arthroplasty, rheumatoid vasculitis and elty’s syndrome requiring splenectomy if it remains unaddressed. Still now researchers are unable to know the exact cause of this disease. However, it is believed that age, gender, genetics and environmental exposure (cigarette smoking, air pollutants and occupational) play a role in development of RA. As there is no cure for RA, the treatment goals are to reduce the pain and stop/slow the further damage. The identification of novel autoantibodies has improved diagnostic accuracy, and newly developed classification criteria facilitate the recognition and study of the disease early in its course. New clinical assessment tools are able to better characterize disease activity states, which are correlated with progression of damage and disability and permit improved follow up. In addition, better understanding of the pathogenesis of RA through recognition of key cells and cytokines has led to the development of targeted disease-modifying antirheumatic drugs. Altogether, the improved understanding of the pathogenetic processes involved, rational use of established drugs and development of new drugs and reliable assessment tools have drastically altered the lives of individuals with RA over the past 2 decades. In this review, we discuss the epidemiology, pathophysiology, diagnosis and management of RA. Keywords: Rheumatoid arthritis, Pathogenesis, Disease modifying anti-arthritic drugs, Genetics, Environmental, Autoantibodies