rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis (often called RA) is a chronic(long-standing) disease that damages the joints of the body.

230 NOVEMBER 2009

INTRODUCTION• Rheumatoid arthritis affects approximately 1% of

world population, with women developing the condition three times more than men.

• Juvenile rheumatoid arthritis (JRA) causes joint inflammation and stiffness for more than six weeks in a child aged 16 or younger.

• Even though infectious agents such as viruses, bacteria, and fungi have long been suspected, the cause of rheumatoid arthritis is unknown.

330 NOVEMBER 2009

An example showing the differences between a normal, healthy joint, a joint affected by osteoarthritis, and one affected by rheumatoid arthritis.

430 NOVEMBER 2009

Signs and symptoms•The symptoms of rheumatoid arthritis come and go, depending on the degree of tissue inflammation.

•Symptoms can include fatigue, lackof appetite, low-grade fever, muscle and joint aches, and stiffness.

530 NOVEMBER 2009

Diagnosis

Blood test X-ray

630 NOVEMBER 2009

TREATMENT•Two classes of medications are used in treating rheumatoid arthritis:

1.fast-acting "first-line drugs" and

2.slow-acting "second-line drugs.“

•Symptomatic pain relief can often be achieved with oral acetaminophen (Tylenol and others) or OTC topical preparations.

730 NOVEMBER 2009

The areas of the body, other than the joints, that are affected by rheumatoid inflammation are treated individually.

830 NOVEMBER 2009

MARKET SHARE OF DIFFERENT CLASSES

30 NOVEMBER 2009 9

OVERALL MARKET SHARE OF DRUGS

30 NOVEMBER 2009 10

SURVEY NSAIDs

DRUGS BRANDS STARS

Hydroxychloroquine

HYDROCAB **

ACETYLSALICYL-ATE

ACE-PROXYVON

***

NAPROXEN NAPROSYN *

IBUPROFEN ABUFEN-C *

ETODOLAC ETOLOR *

PARACETAMOL CALPOL ****

DICLOFENAC MISONAC **

CELECOXIB CELEDOL *

D-PENICILLAMINE CILAMIN *

AURANOFIN AUROCRIS *

Immunosuppressive drugs

DRUGS BRANDS STARS

Azathioprine

imuran *

Cyclophosphamide

cycloxan *

chlorambucil

leukeran *

cyclosporin

Sandimmune neoral

*

methotrexate

folitrax ***corticosteroids

DRUGS BRANDS STARS

prednisolone

wysolone

***11

1.http://kidshealth.org/parent/general/body_basics/bones_muscles_joints.html. assessed on 17/9/09.

2. Majithia V, Geraci SA (2007). "Rheumatoid arthritis: diagnosis and management". page no: 936–9. 3. Landré-Beauvais AJ (1800). La goutte asthénique primitive (doctoral thesis). Paris. "The first

description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800". Joint Bone Spine 68 (2): 130–43.

4. Turesson C, O'Fallon WM, Crowson CS, Gabriel SE, Matteson EL (2003). "Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years". page no: 722–7.

5. Westwood OM, Nelson PN, Hay FC (April 2006). "Rheumatoid factors: what's new?". Rheumatology (Oxford) page no: 379–85.

6. Nishimura K, Sugiyama D, Kogata Y, et al (June 2007). "Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis" page no:797–808.

7. Arnett F, Edworthy S, Bloch D, McShane D, Fries J, Cooper N, Healey L, Kaplan S, Liang M, Luthra H (1988). "The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.". Arthritis Rheum page no: 315–24.

8.O'Dell J (2004). "Therapeutic strategies for rheumatoid arthritis.". N Engl J Med page no : 2591–602.

1230 NOVEMBER 2009

9.Hasler P (June 2006). "Biological therapies directed against cells in autoimmune disease.". Springer Semin Immunopathol page no:443–56.

10. Vital E, Emery P (Sep 15 2005). "Advances in the treatment of early rheumatoid arthritis.".page no: 1002, 1004.

11.http://www.fda.gov/Drugs/ResourcesForYou/HealthProfessionals/ucm107046.htm assessed on

12. Edwards J, Szczepanski L, Szechinski J, Filipowicz-Sosnowska A, Emery P, Close D, Stevens R, Shaw T (2004). "Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis.".page no: 2572–81.

13. Fresenius HemoCare, Inc., "New Hope for Rheumatoid Arthritis Patients," press release, September 17, 1999.

14.Hart FD (March 1976). "History of the treatment of rheumatoid arthritis".page no: 763–5. 15. Franke A, Reiner L, Pratzel HG, Franke T, Resch KL (August 2000). "Long-term efficacy of radon

spa therapy in rheumatoid arthritis--a randomized, sham-controlled study and follow-up". Page no:894–902..

16.S. Wright, M. Ware and G. Guy (2006). "The use of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis )".page no: 781.

17. http://www.ayurveda-herbal-remedy.com/discover-ayurveda/amavata.html 18. http://holisticonline.com/Remedies/Arthritis/arth_RA_homeopathy.htm

1330 NOVEMBER 2009

Thank - youThank - you