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Overview

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Symptoms

Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:

Causes

Rheumatoid arthritis is an autoimmune disease. Normally, your immune system helps protect your body from infection and disease. In rheumatoid arthritis, your immune system attacks healthy tissue in your joints. It can also cause medical problems with your heart, lungs, nerves, skin and more.

Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more likely to react to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.

Risk Factors

  • Your sex: Women are more likely than men to develop rheumatoid arthritis.
  • Age: Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
  • Family history: If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
  • Smoking: Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease.
  • Excess weight: People who are overweight appear to be at a somewhat higher risk of developing rheumatoid arthritis.

Complications

  • Osteoporosis: Rheumatoid arthritis and some medications used to treat it increase your risk.
  • Rheumatoid nodules: Firm bumps of tissue most commonly form around pressure points, such as elbows.
  • Dry eyes and mouth: Many people with rheumatoid arthritis develop Sjogren's syndrome.
  • Infections: Rheumatoid arthritis and its treatments can impair the immune system, leading to increased infections.
  • Abnormal body composition: The proportion of fat to lean mass is often higher in people with rheumatoid arthritis.
  • Carpal tunnel syndrome: Inflammation in the wrists can compress nerves affecting the hand.
  • Heart problems: Rheumatoid arthritis increases your risk of hardened arteries and inflammation of the heart's sac.
  • Lung disease: Increased risk of inflammation and scarring in lung tissues.
  • Lymphoma: Rheumatoid arthritis increases the risk of lymphoma.

Inclusion Criteria

  • Diagnosis: Confirmed diagnosis of RA according to ACR/EULAR criteria.
  • Active Disease: Moderate to severe active RA despite conventional DMARDs or biologics.
  • Age Range: Adults, typically 18 to 75 years.
  • Informed Consent: Capacity to give informed consent.

Exclusion Criteria