Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (2022)

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Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (1)

Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (2)

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Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (4)

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Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (10)Pharmacoeconomic evaluation of costs of rheumatoid arthritis therapy with selected biological treatment (11)

6/2018
vol. 56

Original paper

Krzysztof Kowalik

,

Małgorzata Węgierska

,

Tacjana Barczyńska

,

Sławomir Jeka

Reumatologia 2018; 56, 6: 340-345

Online publish date: 2018/12/23

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Introduction

Among autoimmune diseases, rheumatoid arthritis (RA) is the most common chronic inflammatory disease of the joints. Its pathogenesis is still not fully understood, but the gained knowledge has contributed to the development of modern treatment. The introduction of biological therapy for RA has been a breakthrough in the standard approach to the treatment of this disease. In most patients, their use in the treatment of RA results in a rapid therapeutic effect in the form of lowering disease activity and improving functional status.
The proven efficacy of biological therapy for RA should result in its widespread use. Nevertheless, in order to be able to implement such a solution, large financial expenditures are needed. The increasing costs of medical services, with still limited resources dedicated to healthcare, have made it necessary to make economic evaluations of health programs. Pharmacoeconomic analysis, by comparing the costs and outcomes of alternative therapies, provide a clear overview of available treatments. Their goal is to provide reliable, evidence-based information to help to decide on the best treatment regimen.

Material and methods

The study material was retrospectively collected in the Rheumatology and Systemic Tissue Diseases Clinic and Rheumatology Outpatient Clinic in dr. Jan Biziel University Hospital No. 2 in Bydgoszcz in the years 2009–2014. Data are based on the records of patients with rheumatoid arthritis diagnosed according to the 1987 ACR criteria, who were treated with etanercept, infliximab, and adalimumab. For the analysis, 104 patients were enrolled.
Patients were divided into 3 groups:
•Patients taking infliximab (INF) formed a group of 43 persons (30 women and 13 men) aged 27 to 71 years (average age 47 years). At the time of initiation of biological therapy, men had RA for an average of 6.5 years, women for 9 years.
•Patients taking etanercept (ETA) formed a group of 27 persons (24 women and 3 men) aged 20 to 60 years (average age 51 years). At the time of initiation of biological therapy, men had RA for an average of 13 years, women for 12 years.
•Patients taking adalimumab (ADA) formed a group of 34 persons (23 women and 11 men) aged 25 to 77 years (average age 54 years). At the time of initiation of biological therapy, men had RA for an average of 4.5 years, women for 8 years.
Patients have received medications under the National Health Fund (Narodowy Fundusz Zdrowia – NFZ) therapeutic programs. Each patient had to meet the required inclusion and exclusion criteria as prescribed in the rules of the therapeutic program.
Laboratory tests upon enrollment in the program and at the monitoring visit were performed before treatment and in the period within 90 days (±14 days) after the first dose. Regardless of the chosen drug in therapy, the most commonly performed laboratory examinations were: determination of C-reactive protein concentration (CRP), erythrocyte sedimentation rate (ESR), blood morphology, creatinine, sodium, and potassium levels, and determination of liver enzyme activity – alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
In the present study, the pharmacoeconomic analysis included direct and indirect medical costs. Direct medical costs included costs for the purchase of medications, diagnostic and imaging costs, medical consultations and hospitalization costs.
The costs of laboratory tests and imaging examinations and services provided by the hospital were obtained on the basis of the price list of the hospital’s medical services. Prices of biological medications were obtained from the hospital pharmacy in December 2014, while the prices of other medications were obtained from a public pharmacy. Prices of biosimilar medications (Benepali and Erelzi) were established on the basis of the lists of reimbursed medications as of November 1, 2017.
The indirect costs analyzed in the study included costs related to reduced productivity, such as disability benefits, rehabilitation benefits, and sickness absences. The obtained data came from the Polish Social Insurance Institution (ZUS), branches in Bydgoszcz, Toruń, and Chełmno. The consent to data processing, including information on benefits from ZUS, was obtained from 85 patients.

Results

The analysis included all direct medical costs incurred by the hospital and the patient, as well as indirect costs outside the healthcare sector – that is, ZUS benefits (disability benefits, rehabilitation benefits, and sickness absences). Direct medical costs are also presented from the perspective of the payer, NFZ, taking into account the cost and percentage share of medical expenses.
The analysis concerned resources used since the beginning of treatment with a given biological medication for 24 months or earlier if disease remission occurred.
Direct medical costs were calculated by summing up:
•costs of diagnostic examinations,
•hotel costs,
•costs of medications: biological and accompanying treatment,
•costs of medical consultation.
For the costs of biological medications, in the case of infliximab, the cost of the infusion fluids needed to prepare the medication has been added. The direct total medical costs are shown in Table I.
In all analyzed treatment regimens, the main factor that generates about 90% of total costs was the purchased biological medications.
A cost-benefit analysis was carried out in the study using biosimilar medications present on the market in relation to the treatment regimens. In Poland, there are currently two medications that have counterparts in the form of biosimilar medications, that is, infliximab (Remicade) – Inflektra and Remsima, and etanercept (Enbrel) – Benepali and Erelzi. The total cost of biological treatment also includes the cost of other biological medications, because in the event of intolerance, side effects, or lack of response to infliximab, patients are switched to another therapy: with etanercept, adalimumab, or rituximab. The simulation of using Inflectra instead of infliximab is shown in Table II.
Considering the total cost, if only Inflectra were used in therapy, PLN 18 151.98 per patient could be saved, and in the case of Remsima, PLN 16 385.14. In less than 19 months, to use infliximab for 43 patients, PLN 780 475.80 more would have to be spent than in the case of the biosimilar medication Inflectra, and PLN 704 561 in the case of Remsima.
In a similar way, computations are presented comparing etanercept with the biosimilar medications Benepali and Erelzi. The cost of infliximab treatment also includes the cost of medications used in the case of intolerance, side effects, or lack of response to treatment. For both medications (Infliximab and Remsima), the cost of the infusion fluids needed to prepare them should be added.
Because Inflectra and Remsima were introduced to the Polish market in 2014, there are no long-term data on tolerability and adverse events. For this reason, the above calculations are estimated.
An analysis of indirect costs generated outside the healthcare sector was conducted, related to reduced patient productivity – ZUS benefits (disability benefits, rehabilitation benefits, and sickness absences). The analysis included the patient’s follow-up period in the study until the remission of the disease, or for a period of 24 months.
Approvals were obtained from 85 patients (27 from the adalimumab group, 21 from the etanercept group, 37 from the infliximab group) for the processing of personal data, including data on ZUS benefits. A general summary of the number of people generating indirect costs is presented in Table III.
According to the data obtained from ZUS, the highest indirect costs per patient were generated by the adalimumab treatment group. Patients receiving infliximab and etanercept had lower values of ZUS benefits.
Total costs include both direct and indirect costs related to biological treatment. Figure 1 shows the share of total costs taking into account the cost of a biosimilar medication (Inflectra). The percentage share of individual costs is shown in Table IV.
The highest total cost is generated by treatment with adalimumab, followed by etanercept, and infliximab. Of the costs analyzed, a significant majority was for biological treatment. On average, the amount needed to be spent per patient ranges from PLN 56 868.24 in the case of infliximab to PLN 74 333.82 in the case of adalimumab. These amounts account for around 70% of total costs. Indirect costs range from PLN 16 767.43 for etanercept to PLN 22 464.49 for adalimumab and represent a percentage that fluctuates within 22% of the total value. Only in the case of etanercept does this value drop to about 19%.
The study compares 3 biological therapies used in the therapeutic health program reimbursed by NFZ: infliximab, etanercept, and adalimumab. Pharmacoeconomic analysis has been carried out to provide a full picture of costs. The study covered both direct and indirect costs. The juxtaposition of all direct costs has shown that the most cost-effective therapy is infliximab treatment. This also applies to total costs per patient.

Discussion

The RA morbidity in Europe and North America is 0.5–1% of the population [1]. Modern treatment of RA requires not only huge medical knowledge, but also great clinical experience. Current, standardized therapy with disease-modifying antirheumatic drugs (DMARDs) does not allow for low disease activity or remission in all patients. The alternative is the use of biological therapy. In Poland, about 1% of RA patients have access to up-to-date treatment [2]. Patients are included in the therapeutic program implemented by the NFZ. The NFZ budget for biological treatment, although increasingly large, does not provide access for most patients who need biological treatment. The situation in other countries of Central and Eastern Europe is quite different (Table V).
Considering the rising costs and needs for other healthcare services, it seems doubtful to allocate sufficient funds to cover the current need for biological treatment. Patients whose standard DMARD treatment does not produce adequate results and does not slow the progress of the disease are forced to use disability pension or sickness absence, whereas a well-timed diagnosis combined with rapid and effective implementation of biological therapy provides a significant reduction in the activity of the disease and even the occurrence of remission and thus the return of the patient to full professional activity [3].
According to available sources, indirect costs, both within and outside the health service sector, are several times higher than direct costs associated with the treatment of RA [4]. According to the analysis, increased spending on biological treatment would significantly reduce expenditure in the indirect costs sector [5]. This does not mean, however, that savings should not be sought in the case of direct costs. A number of sources and own research confirm that approximately 90% of the expenditure associated with the use of biological therapy is the cost of purchasing the medications themselves [4, 6, 7].
Despite many publications indicating that the introduction of more widely available biological therapy would result in higher GDP values due to the professional activity of the patients, NFZ continues to allocate too low funds for this purpose [9–11].The conclusions drawn from the analysis of the organization of the rheumatological system mainly focus on the poor treatment of young people with RA, refraining from attempts to maintain the occupational activity of RA patients and incurring increasingly higher costs of development of motor disability in patients before the age of 65 [12].
Unfortunately, in Poland, there is still a lack of a well-organized healthcare system and cooperation among decision makers. The situation in the field of healthcare is constantly changing. However, even if on the level of the assumptions and priorities the new solutions are evaluated positively, in reality there is a real problem with their effectiveness. Therefore, the decision to introduce an appropriate therapy should be preceded by extensive pharmacoeconomic analysis. In this study, both direct and indirect costs were calculated for 3 biological therapies. In line with the recommendations of Good Pharmacoeconomic Practice (GDP), when considering the choice of therapy, consideration is given to the economic balance of both the costs of treatment and the social costs incurred as a result of the loss of the patient’s productivity. However, indirect costs were mainly focused on costs obtained from ZUS: disability benefits, rehabilitation benefits, and sickness absences. No GDP calculation was made due to the lack of reliable data on RA. The available data show that GDP per capita in Poland in 2014 was at the level of $ 14 411.495 (with a dollar exchange rate of PLN 4.14, it is about PLN 59 663.60) [12]. Indirect costs generate very large social expenditures. About 12% of sickness absences are associated with rheumatic diseases [12]. The estimated social costs of lost productivity, that is abstinence, and informal care, measured by the human capital method, amount to approximately PLN 2 778 million [5].
However, it is important to note that data may be understated due to limitations in access to ZUS and KRUS (Agricultural Social Insurance Fund) data. In the meantime, ZUS expenses related to RA amount to about PLN 211 million per year [13, 14]. Among the group of diseases of unknown etiology, which are characterized by chronic inflammation and lack of a proper immune response, ZUS allocates the highest benefits for RA. The report „Move to Work” (M2W) shows that the highest annual costs per working person associated with overall loss of productivity are generated by RA patients – approximately PLN 29 700 [14].
Looking at the results of research conducted under the „RA: Join the Fight” campaign, these costs should not be surprising. As many as 47% of respondents considered that RA had a negative impact on their careers or their ability to work [13]. According to ZUS data, in 2011, as a result of sickness absences, patients with RA missed 555 thousand work days, in 2012 – 561 thousand days [13, 14], in 2013 – about 552 thousand days, and in 2014 – 574 thousand days [15].
It is estimated that after 2 years after the diagnosis of RA, every third patient is unable to perform professional activity. After ten years, this number increases to 50% [16]. The persistent disease progression in RA patients generates not only higher direct costs, but also higher indirect costs. Becoming disabled is the worst possible scenario, so it is important to have a well-functioning system that will provide the right treatment and keep the patients in professional activity. One should consider the best solutions that would increase the availability of biological treatment in Poland. It is not enough to change the criteria of the therapeutic program, but also the availability of new therapies for patients must be increased.

Conclusions

Therefore, given the Polish financial conditions, the best solution now is to reduce the prices of biological medications. This is possible through the introduction of biosimilar medications that, when placed on the market, reduce the price of the original medication, as is currently the case with Remicade and Enbrel. The introduction of Inflectra and Remsima, as well as Benepali and Erelzi, has reduced the price base of original medications to similar levels of treatment with biosimilar medications. The wider use of biological treatment would also reduce indirect costs.

The authors of this publication had no research support. The rights revenue was paid by Stowarzyszenie Zbiorowego Zarządzania Prawami Autorskimi Twórców Dzieł Naukowych i Technicznych KOPIPOL of Kielce from fees collected pursuant to Article 20 and Article 201 of the Copyright and Neighbouring Rights Act.
Wynagrodzenie autorskie sfinansowane zostało przez Stowarzyszenie Zbiorowego Zarządzania Prawami Autorskimi Twórców Dzieł Naukowych i Technicznych KOPIPOL z siedzibą w Kielcach z opłat uzyskanych na podstawie art. 20 oraz art. 20ą ustawy o prawie autor­skim i prawach pokrewnych.
Sławomir Jeka has conducted lectures during conferences, conventions and business meetings in cooperation with pharmaceutical companies Pfizer, MSD, Sandoz, Roche, Eli Lilly, UCB, Abbvie, Astra Zeneca, Novartis.
The other authors declare no conflict of interest.

References

1. Felson D, Anderson J, Boers M, et al. American College of Rheumatology preliminary definitions of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38: 727-735.
2. Kobelt G, Kasteng F. Access to innovative treatments in rheumatoid arthritis in Europe. A report prepared for the European Federation Of Pharmaceutical Industry Associations (EFPIA). 2009: 1-92.
3. Orlewska E, Wiland P. Access to biologic treatment for rheumatoid arthritis in Central and Eastern European (CEE) countries. Med Sci Monit 2011; 17: 1-13.
4. Ruszkowski J, Leśniowska J, Gierczyński J, et al. Koszty pośrednie i bezpośrednie leczenia reumatoidalnego zapalenia stawów w Polsce. Farmakoekonomika 2009; 13: 3-9.
5. Wałdysiuk M. Mulitmedial presentation: Koszty pośrednie w ocenie technologii medycznych. Metodyka i rekomendacje dla Polski (Indirect costs in medical technology assessment. Methodology and recommendations for Poland). XXIII Economic Forum, Krynica-Zdrój 2014.
6. Głuszko P, Filipowicz-Sosnowska A, Tłustochowicz W. Reumatoidalne zapalenie stawów. Reumatologia 2012; 50: 83-90.
7. Moreland LW, Schiff MH, Baumgartner SW, et al. Etanercept therapy in rheumatoid arthritis. A randomized, controlled trail. Ann Intern Med 1999; 130: 478-486.
8. Stajszczyk M. Raport. Leczenie biologiczne w chorobach reumatycznych w Polsce w 2013 r. Polskie Towarzystwo Reumatologiczne, Warszawa 2013: 1-20.
9. Koligat D, Paczkowska A, Leszczyński P, et al. Analiza kosztów farmakoterapii u pacjentów z reumatoidalnym zapaleniem stawów leczonych biologicznymi lekami modyfikującymi przebieg choroby. Now Lek 2013; 82: 394-398.
10. Koligat D. Kalkulacja kosztów leczenia oraz ocena jakości życia pacjentów z reumatoidalnym zapaleniem stawów. Katedra i Zakład Farmakoekonomiki i Farmacji Społecznej Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, Poznań 2014.
11. Report on biological treatment. Porównajmy się z innymi krajami (Let’s compare ourselves with other countries): http://www.rynek zdrowia.pl/Serwis-Reumatologia/Raport-nt-leczenia-biologicznegoPorownajmy-sie-z-innymi-krajami,136600,1011.html (access from 26.04.2018).
12. Kotarba-Kańczugowska M, Kucharski K, Linder-Kopiecka I, et al. JA PACJENT! Perspektywa Organizacji Pacjenckich na Stan Opieki Reumatologicznej w Polsce. Raport Organizacji Pacjenckich, Warszawa 2014: 115-118. http://zzsk.org.pl/documents/JaPacjentRaportStanuReumatologii2014.pdf (access from 26.04.2018).
13. Wróbel P. Chorzy mają głos. Rynek Zdrowia 2013; 9: 22-26.
14. Bebrysz M, Fedyna M, Rutkowski J, et al. Przewlekłe choroby zapalne mediowane immunologicznie – ocena kosztów pośrednich w Polsce. Central and Eastern European Society of Technology Assessment in Health Care, Kraków 2014: 29-58.
15. Bogusławski S. Reumatoidalne zapalenie stawów. Wydatki na leczenie RZS w Polsce. Sequence HC Partners Sp. z o.o., Warszawa 2015: 2-8.
16. Zheltoukhova K, Bevan S, Reich A. Zdolni do pracy? Choroby układu mięśniowo-szkieletowego a rynek pracy w Polsce. The Work Foundation, London 2011: 1-116.

Copyright: © 2018 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

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FAQs

What age does rheumatoid arthritis start? ›

RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults — usually between the ages of 16 and 40 — it's called young-onset rheumatoid arthritis (YORA).

What is the root cause of rheumatoid arthritis? ›

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this. Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

How to treat rheumatoid arthritis in knees? ›

Treatment
  1. NSAIDs . Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. ...
  2. Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. ...
  3. Conventional DMARDs . ...
  4. Biologic agents. ...
  5. Targeted synthetic DMARDs .
18 May 2021

How did you know you had rheumatoid arthritis? ›

Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints. Joint stiffness that is usually worse in the mornings and after inactivity. Fatigue, fever and loss of appetite.

What is the latest treatment for rheumatoid arthritis? ›

New Treatments for Rheumatoid Arthritis - Latest FDA Approvals
DrugDrug Class
golimumab (Simponi)tumor necrosis factor (TNF) blocker
rituximab (Rituxan)CD20-directed cytolytic antibody
abatacept (Orencia)selective T cell costimulation modulator
adalimumab (Humira)tumor necrosis factor (TNF) blocker
12 more rows

What is the most common cause of death in patients with rheumatoid arthritis? ›

Compared with people without the disease, people with rheumatoid arthritis are nearly twice as likely to die before the age of 75 and are more likely to succumb to cardiovascular disease and respiratory problems, study finds.

What virus causes rheumatoid arthritis? ›

Viruses may also play a role in triggering RA. According to the Cleveland Clinic, people with RA, on average, have higher levels of antibodies to the Epstein-Barr virus (which causes mononucleosis) than the general population. The Epstein-Barr virus isn't the only virus suspected as an infectious agent in RA.

Can stress cause rheumatoid arthritis? ›

The longer you're exposed to stress, the more destructive the inflammation can become. In a PLoS One study, people with RA identified stress as a trigger for disease flare-ups. Arthritis symptoms contribute to stress, especially when they're unrelenting. Constant pain, fatigue, and poor sleep create a vicious cycle.

Which bacteria causes rheumatoid arthritis? ›

The pathogenic role of infection in RA is also suggested by studies using arthritis animal models. Among the RA associated microbes, P. gingivalis shows the greatest promise as a significant contributor to RA etiology.

What is the safest treatment for rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

What is the most successful drug for rheumatoid arthritis? ›

Methotrexate is often the first drug prescribed for people newly diagnosed with rheumatoid arthritis. RA patients take this medication weekly, alone or in combination with other medications.
...
The generic names for commonly used DMARDs include:
  • Hydroxychloroquine.
  • Methotrexate.
  • Sulfasalazine.
  • Azathioprine.
  • Lefludomide.

Which treatment is best for rheumatoid arthritis? ›

Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain.
...
Disease-modifying anti-rheumatic drugs (DMARDs)
  • methotrexate.
  • leflunomide.
  • hydroxychloroquine.
  • sulfasalazine.

What time of day is rheumatoid arthritis worse? ›

The joint pain associated with rheumatoid arthritis is usually a throbbing and aching pain. It is often worse in the mornings and after a period of inactivity.

What is Stage 1 rheumatoid arthritis? ›

The stage 1 is the early stage of rheumatoid arthritis. At this stage, patients experience joint tissue inflammation that causes joint pain, stiffness, swelling, redness, and tenderness. The joint lining known as the synovium becomes inflamed. There's no damage to the bones.

Does rheumatoid arthritis ever just go away? ›

Rheumatoid arthritis is a lifelong disease. When it's treated, it may go away for a little while, but it usually comes back. It's important to see your doctor as soon as symptoms begin. The earlier you start treatment, the better your outcome.

What is the safest biologic for rheumatoid arthritis? ›

What is the safest biologic for rheumatoid arthritis? All biologics carry a risk of side effects such as infection. However, research has found that Abatacept carries a lower risk of serious infection than other biologics for RA.

What is the first line treatment for rheumatoid arthritis? ›

NSAIDs, salicylates, or cyclooxygenase-2 inhibitors are used for initial treatment of rheumatoid arthritis to reduce joint pain and swelling.

What is the best injection for rheumatoid arthritis? ›

Methotrexate is a drug used to treat rheumatoid arthritis (RA) and and other inflammatory conditions. Nearly 60% of all rheumatoid arthritis patients are currently on or have been on methotrexate. Methotrexate is recommended as the first treatment for RA by the American College of Rheumatology.

How long can you live with rheumatoid arthritis? ›

It's possible to live a long life with RA, but it is estimated that the disease can potentially reduce life expectancy by 3 to 10 years. There's no cure for RA, although remission can happen.

Can I live a normal life with rheumatoid arthritis? ›

Many people can live a healthy, active life with RA. For example, disease-modifying antirheumatic drugs (DMARDs) have become an effective and widely available medication for people with RA. These drugs work by suppressing the immune system and minimizing the damage that it does to joint tissue.

What should you not do if you have rheumatoid arthritis? ›

If you fail to follow the treatment regimen — by not filling prescriptions, not taking medication as directed, not exercising, or skipping appointments — there is an increased risk of worsening symptoms and disease activity.

Can Covid trigger rheumatoid arthritis? ›

Multiple studies have reported autoantibodies in patients with COVID-19, particularly anti-cardiolipin, anti-β2-glycoprotein I and antinuclear antibodies. 1 2 Anti-citrullinated protein antibodies (ACPA) and flaring of rheumatoid arthritis (RA) after SARS-Cov-2 infection have also been described.

Does RA affect your brain? ›



People with RA are more likely to have narrowed or blocked arteries in the brain – the result of systemic inflammation. This can cause problems with memory, thinking and reasoning.

Can you treat RA without medication? ›

Many doctors recommend heat and cold treatments to ease rheumatoid arthritis symptoms. Each offers different benefits: Cold: It curbs joint swelling and inflammation. Apply an ice pack to the affected joint during an RA flare-up, for instance.

Is ice good for rheumatoid arthritis? ›

Does Cold Therapy Help Arthritis Pain? Yes. Cold packs numb the sore area and reduce inflammation and swelling. Ice packs are especially good for joint pain caused by an arthritis flare.

What is the normal progression of rheumatoid arthritis? ›

The four stages of rheumatoid arthritis are known as synovitis, pannus, fibrous ankylosis, and bony ankylosis.

Can vitamin D reverse rheumatoid arthritis? ›

Another study revealed that a higher intake of vitamin D and omega-3 fatty acids may be associated with better treatment results in patients with early rheumatoid arthritis.

What activates rheumatoid arthritis? ›

For most people, the flare risk increases when treatments are tapered or stopped. Other triggers include overexertion, stress, infection or poor sleep.

Are biologics better than methotrexate? ›

Biologics plus methotrexate improved symptoms more than methotrexate alone. Biologics plus methotrexate improved symptoms more than methotrexate alone. Biologics plus methotrexate did not improve symptoms more than biologics alone. Biologics plus DMARDs improved symptoms more than DMARDs alone.

When would you use biologics for rheumatoid arthritis? ›

Aggressive treatment can help prevent long-term disability from rheumatoid arthritis. So if you have moderate to severe RA and don't respond to traditional disease-modifying antirheumatic drugs (DMARDs), your doctor will probably say it's time for a biologic.

How effective are biologics for rheumatoid arthritis? ›

While biologics don't cure RA, they can slow its progression. They can also cause fewer side effects than other kinds of drugs. Your doctor may give you a biologic drug alongside or in place of the drug methotrexate, an anti-rheumatic.

What vitamin deficiency causes arthritis? ›

Another study found that vitamin D deficiency is common in people with rheumatoid arthritis (RA), and may be linked to musculoskeletal pain. Not having enough vitamin D can: affect your immune system. reduce calcium and phosphorus levels.

What drinks are good for arthritis? ›

Best Drinks for Arthritis
  • Tea. Tea is one of the most-studied drinks when it comes to its benefits for arthritis patients. ...
  • Coffee. Research shows coffee also has antioxidant polyphenols. ...
  • Milk. ...
  • Juices. ...
  • Smoothies. ...
  • Alcohol. ...
  • Water.

What is the best herbal medicine for rheumatoid arthritis? ›

9 Herbs to Fight Arthritis Pain
  • Aloe Vera.
  • Boswellia.
  • Cat's Claw.
  • Eucalyptus.
  • Ginger.
  • Green Tea.
  • Thunder God Vine.
  • Turmeric.
1 Jun 2020

How can I reverse rheumatoid arthritis? ›

Rheumatoid arthritis

Like other forms of arthritis, RA can't be reversed. Even if you show evidence of low inflammation and your joints aren't swollen and tender, your doctor may want you to continue taking some medication to avoid a flare of the disease.

What is a natural alternative to methotrexate? ›

A 2015 study of 207 patients with rheumatoid arthritis showed that Tripterygium wilfordii Hook F (TwHF), an herb used in Chinese traditional medicine, was superior to methotrexate monotherapy - as either a monotherapy itself or in combination with methotrexate.

Does drinking water help with rheumatoid arthritis? ›

Staying hydrated is vital when you live with arthritis. Hydration is key for flushing toxins out of your body, which can help fight inflammation, and well-hydrated cartilage reduces the rate of friction between bones, meaning you can move more easily.

Why is rheumatoid worse at night? ›

In people with rheumatoid arthritis (RA), the body releases less of the anti-inflammatory chemical cortisol at night, increasing inflammation-related pain.

What is the most painful type of arthritis? ›

Rheumatoid arthritis can be one of the most painful types of arthritis; it affects joints as well as other surrounding tissues, including organs. This inflammatory, autoimmune disease attacks healthy cells by mistake, causing painful swelling in the joints, like hands, wrists and knees.

How serious is rheumatoid arthritis? ›

Rheumatoid arthritis (RA) has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death. Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes.

How do you stop arthritis from progressing? ›

Slowing Osteoarthritis Progression
  1. Maintain a Healthy Weight. Excess weight puts additional pressure on weight-bearing joints, such as the hips and knees. ...
  2. Control Blood Sugar. ...
  3. Get Physical. ...
  4. Protect Joints. ...
  5. Choose a Healthy Lifestyle.

How does RA affect the eyes? ›

The most common eye-related symptom of rheumatoid arthritis is dryness. Dry eyes are prone to infection, and if untreated, severe dry eyes can cause damage to the cornea, the clear, dome-shaped surface of the eye that helps your eye focus.

Do you have to take biologics forever? ›

Once you start biologics, you will likely continue to take them, even in remission. If you stop taking biologics, they may not work as well when you start taking them again. This is because your body can build up antibodies that make the drug less effective.

Do you take methotrexate forever? ›

It's important that you don't stop taking methotrexate unless your provider tells you to. Your arthritis symptoms may return — and they may even be worse than before. After about 6 months, your provider will likely reevaluate your treatment plan if your symptoms have not improved.

How can I lower my RA factor naturally? ›

Keep reading to find out more about these and other ways to relieve your RA pain.
  1. Sleep. Getting enough sleep is important for everyone, but it's especially important for those with RA. ...
  2. Exercise. ...
  3. Yoga. ...
  4. Tai chi. ...
  5. Acupuncture. ...
  6. Massage. ...
  7. Mindfulness. ...
  8. Support groups.
6 Mar 2020

Can you suddenly develop rheumatoid arthritis? ›

In a few people with RA -- about 5% to 10% -- the disease starts suddenly, and then they have no symptoms for many years, even decades. Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.

What are the five signs of rheumatoid arthritis? ›

What are the signs and symptoms of RA?
  • Pain or aching in more than one joint.
  • Stiffness in more than one joint.
  • Tenderness and swelling in more than one joint.
  • The same symptoms on both sides of the body (such as in both hands or both knees)
  • Weight loss.
  • Fever.
  • Fatigue or tiredness.
  • Weakness.

What is Stage 1 rheumatoid arthritis? ›

The stage 1 is the early stage of rheumatoid arthritis. At this stage, patients experience joint tissue inflammation that causes joint pain, stiffness, swelling, redness, and tenderness. The joint lining known as the synovium becomes inflamed. There's no damage to the bones.

Can a 20 year old get rheumatoid arthritis? ›

Rheumatoid arthritis (RA) is more likely to appear in middle age, but young adults can get RA, too. As many as 8 in 100,000 people aged 18 to 34 get RA.

Can you stop rheumatoid arthritis from progressing? ›

Being on a DMARD or biologic therapy for RA is the best way to prevent progression,” Dr. Lally says. Disease-modifying anti-rheumatic drugs (DMARDs) are usually the first line in medication. “Methotrexate [a DMARD] is the anchor drug for rheumatoid arthritis,” Dr.

Can stress cause rheumatoid arthritis? ›

The longer you're exposed to stress, the more destructive the inflammation can become. In a PLoS One study, people with RA identified stress as a trigger for disease flare-ups. Arthritis symptoms contribute to stress, especially when they're unrelenting. Constant pain, fatigue, and poor sleep create a vicious cycle.

Can Covid trigger rheumatoid arthritis? ›

Multiple studies have reported autoantibodies in patients with COVID-19, particularly anti-cardiolipin, anti-β2-glycoprotein I and antinuclear antibodies. 1 2 Anti-citrullinated protein antibodies (ACPA) and flaring of rheumatoid arthritis (RA) after SARS-Cov-2 infection have also been described.

How long can you live with rheumatoid arthritis? ›

It's possible to live a long life with RA, but it is estimated that the disease can potentially reduce life expectancy by 3 to 10 years. There's no cure for RA, although remission can happen.

What is the safest drug to treat rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

Can you live a normal life with rheumatoid arthritis? ›

Many people can live a healthy, active life with RA. For example, disease-modifying antirheumatic drugs (DMARDs) have become an effective and widely available medication for people with RA. These drugs work by suppressing the immune system and minimizing the damage that it does to joint tissue.

Does Weather Affect rheumatoid arthritis? ›

Some people with RA notice that their symptoms get worse during certain times of the year. Seasonal weather changes may trigger RA flares during the winter, spring, or summer months. Large, high quality studies into the effects of weather on RA are sparse.

Can rheumatoid arthritis affect your brain? ›



People with RA are more likely to have narrowed or blocked arteries in the brain – the result of systemic inflammation. This can cause problems with memory, thinking and reasoning.

How do you slow down rheumatoid arthritis? ›

How Can I Slow Down the Progression of Rheumatoid Arthritis?
  1. Quit smoking, cut down on drinking.
  2. Avoid putting strain on the joints.
  3. Develop a light but regular exercise routine.
  4. Follow an anti-inflammatory diet plan.
  5. Maintain a healthy weight.
  6. Get plenty of rest and sleep.
25 May 2021

Where does RA usually start? ›

The most commonly affected areas during the onset of RA are the small joints in your hands and feet. This is where you may first feel stiffness and an ache. It's also possible for RA inflammation to affect your knees and hips.

Is RA a disability? ›

The Social Security Administration (SSA) considers RA a disability if a person meets the following eligibility criteria: the person's condition is so severe that they will need to be out of work for 12 months or more. the person has gained enough work credits to qualify for disability benefits.

Can rheumatoid arthritis affect your eyes? ›

Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints. However, rheumatoid arthritis occasionally affects other parts of the body — including the eyes. The most common eye-related symptom of rheumatoid arthritis is dryness.

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