“To people living with rheumatoid arthritis today, remission means having prolonged periods of being able to return to everyday activities, without having to think about and accommodate their disease” Bosworth says.
Blocking Inflammatory Pathways
Multiple risk factors, including family history, genetic and environmental factors may play a role in the onset of rheumatoid arthritis. The immune system is activated against the joints and leads to inflammation, which is critical to the progression of the disease. Scientists have identified different pathways of inflammation which may not be exactly the same for each and every rheumatoid arthritis patient. This may be one of the reasons why patients have varying responses to therapies.
“We continue to do research to better understand rheumatoid arthritis and figure out what pathways we can target. Each patient responds differently to treatments and we need more options that can help patients achieve remission,” Dr. Pangan says.
Marwan Bukhari, Ph.D., FRCP, a rheumatologist in the U.K. whose daily work involves deciding which medicine targets the right pathway for patients, says that healthcare providers are now better at eventually combating inflammation, but don’t have the tools to quickly decide which medicine will work when a patient first visits the clinic. He looks forward to the day when a biomarker can provide information about how patients will respond to a given therapy.
“This would really help identify people with moderate disease or whose symptoms are not obvious,” Dr. Bukhari said.
A Powerful Message
Dr. Pangan recalls another patient she saw in her practice.
The patient had lived with rheumatoid arthritis for many years. When she finally got a treatment that worked for her and achieved remission, she came back to the clinic with a powerful message. It’s a message that has stuck with Dr. Pangan.
“She told me she never knew how sick she was until she got better. She forgot what it meant to feel normal,” Dr. Pangan says. “With greater awareness of rheumatoid arthritis and a focus on advancing our scientific understanding of the disease, I am hopeful more patients can get back to feeling normal.”
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
1 Arthritis Foundation. “Why Your RA Went Into Remission, but Relapsed.” https://www.arthritis.org/living-with-arthritis/treatments/plan/remission/rheumatoid-arthritis-remission-and-relapse.php. Accessed on March 11, 2019
2 Mayo Clinic. Rheumatoid Arthritis: Symptoms & Causes. Available at http://www.mayoclinic.org/diseases-conditions/rheumatoidarthritis/home/ovc-20197388. Accessed on March 11, 2019
3 American College of Rheumatology. “Rheumatoid Arthritis.” Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis. Accessed March 11, 2019