Women easy prey of rheumatoid arthritis
Studies show that women are three times more likely to get rheumatoid arthritis than men. It also appears to strike women at a younger age and its symptoms and effects on the body are more severe in women than in men.
But before we look at reasons why women are at a higher risk, we need to first understand what RA is and how it affects the body.
Rheumatoid arthritis is a chronic, autoimmune condition in which a person’s immune cells start attacking the membrane lining around the joints.
This causes joint inflammation and pain, which can last anywhere from a few minutes to several weeks. The smaller joints of the hands and feet are usually affected first.
As the condition progresses, it spreads to the wrists, elbows, ankles, knees, hips and shoulders. Over time, the ligaments that hold the joint together become weak and erode, causing the bone to shift out of place.
Sometimes, this shifting touches nerves in the area, which again leads to intense, and often unbearable pain. If not treated, RA can affect other parts of the body such as eyes, heart, lungs and blood vessels.
Symptoms of RA vary from person to person, but common ones include redness and swelling of the joints, and stiffness that worsens after long periods of rest.
In most people, symptoms come and go, varying in intensity and duration.
Hormones put women at a higher risk
Research shows that the reason why women tend to develop RA at a younger age than men, with symptoms appearing in the third decade of life, is because of the strong influencing role that the hormones estrogen and progesterone play in the development of RA.
Since the levels of these hormones vary from one woman to another, and even in the same woman at different stages of her life - puberty, menstrual cycle, pregnancy, breastfeeding, menopause - RA can be triggered at any point.
However, the precise reason why this happens is still under investigation.
RA is a disease that impacts an individual on several levels: physical pain, discomfort and disfigurement; reduced ability to perform daily tasks; reduced productivity at work; and enormous emotional and psychological stress.
This is why the earlier we can diagnose and treat it, the more we can ensure that patients improve their quality of life.
New treatment offers hope
Global guidelines say that treatment should start within six months after symptoms first emerge. Doctors usually prescribe a class of drugs called ‘disease-modifying antirheumatic drugs (DMARDs)’ which help slow down disease progression.
But some patients do not respond to this treatment and symptoms continue to persist. A new class of drugs called ‘JAK inhibitors’ now offers hope to address this problem.
In the cells, JAKs are part of a ‘signaling pathway’ that increase the production of molecules causing inflammation.
JAK inhibitors block the activity of JAKs, stopping this pathway and preventing inflammation.
And for patients who fear needles, these effective treatments are available as once-daily oral medication. A specialist called a rheumatologist is the best person to make a choice of treatment.
In the last 10 years, RA has changed from being a medically puzzling condition to one that can be managed.
For instance, we now know that in addition to treatment, maintaining a healthy weight and quitting smoking also have a role to play in symptom control.
Both smoking and obesity can worsen RA symptoms and increase the likelihood of developing other conditions such as high blood pressure, which can lead to its own set of complications.
Patients who best manage to control their RA are those who accurately track and report symptoms, adhere to prescribed treatment and make lifestyle changes as advised by the doctor to reduce inflammation triggers.
(The writer, Dr Rajkiran Dudam, is MD Rheumatologist, Hyderabad Rheumatology Center)