Does rheumatoid arthritis control your life?

Imagine not being able to sleep because of pain so severe it keeps you tossing the entire night. During the day, you can barely focus on the simplest tasks, your concentration is gone and just thinking about what you could accomplish if you had a reprieve from the agony leaves you down and depressed.

Catherine Hofstetter, diagnosed with rheumatoid arthritis at only 36, knows exactly what this feels like. She has suffered with RA for over 13 years and it has affected every aspect of her life. “For a normal person, you get up, get showered, dressed, grab some breakfast and head out the door. With RA you have to think about everything you do from the moment you open your eyes.” Daily activities most of us take for granted, such as walking a short distance, opening a jar of coffee or sleeping through the night are made much more difficult by the severe pain, limited range of motion and overwhelming fatigue (even after a good night’s sleep) caused by RA.

Despite the common belief that rheumatoid arthritis (RA) only affects the elderly, the truth is that it can strike anyone. RA is a painful and debilitating joint disease that can target someone as young as twey and affects one in 100 Canadians and three times as many women than men. It is a chronic, auto-immune disease whereby the body’s immune system attempts to destroy its own tissues. Studies show that ten years after onset, more than 50 per cent of RA patients are severely disabled; after 15 years, a startling 60 per cent are unable to work.

For Hofstetter, years of trying to relieve RA symptoms left her discouraged, frustrated and in constant pain. “I tried RA medications like NSAIDS (non-steroidal anti-inflammatory products) and DMARDS (disease modifying anti-rheumatic drugs) but they didn’t work for me,” says Hofstetter, who finally found relief after treatment with a biological product. “There is no way to describe it other than my life has changed drastically since being on a biologic – I get to sleep easier, I stay asleep longer and actually, from time to time, I even wake up feeling refreshed!” she explains.

According to the Arthritis Society, there are four main treatment options for RA sufferers to improve a patient’s quality of life: NSAIDS, such as over-the-counter pain relievers; DMARDS, such as methotrexate; corticosteroids; and newer biological treatments that are prescribed to treat moderate to severe RA in those who have had limited success with more conventional treatments. There are several biological products currently approved by Health Canada to treat RA and this new class of treatment offers encouragement and hope for individuals like Catherine Hofstetter.

Not all medications, including biologicals, are created equal. They differ in terms of how they are administered and how they work. The best person to speak to about treatment for RA is a rheumatologist who can discuss the various treatment options.

Dr. Anthony Russell of the Heritage Medical Research Centre in Edmonton says, “Physicians are paying more attention to issues such as the sleeplessness, fatigue and pain in RA patients – recognizing that quality of life is front and center.” And because RA is a chronic condition, medications that offer safe, effective and sustainable improvement are the subject of great interest to RA sufferers, their families and the medical community.

Dr. Russell was a lead investigator in a recent study presented to the American College of Rheumatology meeting last year, which evaluated the combination of methotrexate and a newer biologic treatment, abatacept (Orencia), recently approved by the Food and Drug Administration (FDA) in the United States for patients who have had only limited success with methotrexate alone. Dr. Russell suggests that the addition of this new type of biological drug, which works differently than other treatments, can be very effective and provide significant and relatively long-lasting improvement with continued use. Abatacept is currently under review by Health Canada.

For more information on RA contact the Arthritis Society of Canada at www.arthritis.ca.

Rheumatoid Arthritis: Fact or Fiction
Only the elderly are affected by rheumatoid arthritis (RA).
Fiction. Anyone can be affected. RA is a painful and debilitating joint disease that can strike a person in their 20’s, 30’s, 40’s and upwards and affects one in 100 Canadians.

Women are more likely to be affected by RA.
Fact. Women are three times more likely to be affected by RA than men.

RA can be cured.
Fiction. Although there is currently no cure for RA, treatments are available to slow down the progression of the disease and to relieve symptoms.

There are four main types of treatments available to RA patients:

Non-steroidal anti-inflammatory drugs (NSAIDS)

Traditional disease-modifying anti-rheumatic drugs (DMARDS)

Corticosteroids

Biological treatments

Many RA sufferers are unable to work.
Fact. Ten years after onset, more than 50 per cent of RA patients are severely disabled; after 15 years, only 4 per cent% are able to work.