TUESDAY, Dec. 3, 2013 (HealthDay News) -- Rheumatoid arthritis
patients can generally look forward to a much better quality of
life today than they did 20 years ago, new research suggests.
The observation is based on a comparative multi-year tracking of
more than 1,100 rheumatoid arthritis patients. All had been
diagnosed with the often severely debilitating autoimmune disease
at some point between 1990 and 2011.
The reason for the brighter outlook: a combination of better
drugs, better exercise and mental health therapies, and a greater
effort by clinicians to boost patient spirits while encouraging
continued physical activity.
"Nowadays, besides research on new drug [treatments], research is mainly focused on examining which treatment works best for which patient, so therapy can become more 'tailor-made' and therefore be more effective for the individual patient," said Cecile Overman, the study's lead author.
Overman, a doctoral student in clinical and health psychology at
Utrecht University in the Netherlands, expects that in another 20
years, rheumatoid arthritis patients will have the same quality of
life as anyone else "if the focus on the whole patient -- not just
the disease, but also the person's mental and physical well-being
-- is maintained and treatment opportunities continue to
The study was released online Dec. 3 in
Arthritis Care & Research.
In rheumatoid arthritis, the body's immune system mistakenly
attacks the joints, the Arthritis Foundation explains. The
resulting inflammation can damage joints and organs such as the
heart. Patients experience sudden flare-ups with warm, swollen
joints, pain and fatigue. Currently there is no cure but a variety
of drugs can treat symptoms and prevent the condition from getting
Up to 1 percent of the world's population currently struggles
with the condition, according to the World Health Organization.
The current study was composed primarily of female rheumatoid
arthritis patients (68 percent). Women are more prone to developing
the condition than men.
Patients ranged in age from 17 to 86, and all were Dutch. Each
was monitored for the onset of disease-related physical and mental
health disabilities for anywhere from three to five years following
their initial diagnosis. Disease activity was also tracked to
The observed trend: a dramatic two-decade drop in physical
disabilities. The researchers also saw a decline in the incidence
of anxiety and depression.
For example, roughly one-quarter of patients diagnosed with
rheumatoid arthritis in 1990 could expect to experience anxiety or
depression after four years of treatment, compared with 12 percent
to 14 percent of patients diagnosed today.
While 53 percent of those diagnosed at the study's launch
struggled with some measure of physical disability after four years
of therapy, that figure dropped to 31 percent among new patients,
the findings showed.
Why? The team suggested that at least some of the
quality-of-life boost seen among rheumatoid arthritis patients
could be attributed to an overall plummet in disease activity --
and ultimately physical disabilities -- during the study period.
This, they said, was a result of overall improvements in treatment
But investigators also pointed out that while overall quality of
life has gotten markedly better over the years, patient
psychological "distress" has not dissipated as much as the onset of
physical disabilities. And this, they warned, argues against
drawing any clear cause-and-effect conclusions based on the current
That said, "pharmacological [drug] treatment has improved a
lot," Overman noted. "[And] treatment has become more intense. To
keep inflammation and disease progression to a minimum, patients
start medication as soon as possible, are monitored more frequently
and medications are combined for optimal efficacy. Furthermore,
effective new anti-inflammatory drugs have become available, such
as the biologic agents."
She added that non-medication treatments -- including exercise
therapy and a form of counseling known as cognitive behavioral
therapy -- have also been shown to help.
The bottom line, Overman said, is: "Today, [rheumatoid
arthritis] patients have a better opportunity of living a valued
life than patients diagnosed with this autoimmune disease two
Dr. John Hardin -- vice president for research at the Arthritis
Foundation, and a professor of medicine at the Albert Einstein
College of Medicine in New York City -- wholeheartedly agreed.
"Today we have a whole new series of drugs that have changed the face of the disease," he said. "All very good drugs. So the challenge now is to find the right drug for the right patient."
Hardin said his foundation is focused on helping to develop
tools and techniques that show beforehand which drug is best for
which patient, to better tailor treatments.
"And I'm very optimistic going forward," he added, "given the new powers of biomedical research, and genetics. I think we have every reason to believe that even better treatments will continue to come along, and we'll know better and better just how to apply those treatments."
For more on rheumatoid arthritis, visit the
U.S. National Library of Medicine.
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