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Although some patients may experience a mild illness with minimal joint damage, in most patients with uncontrolled disease activity, RA will follow a progressive course, leading to increasing degrees of joint destruction, pain, and functional decline.1 Patients may also experience fatigue, weight loss, and extra-articular involvement.1,4,5 These patients tend to be less productive at work or experience such severe symptoms that they are unable to work at all.5
The prevalence of RA is higher in women than in men: women are about 2.5 times more likely to develop RA. 6 Women with RA may also experience disease differently than men. Women with RA tend to have an earlier onset of disease, lower quality of life, and more depressive symptoms than men.6-8 For women with RA who become pregnant, approximately 47% experience persistent or worsening disease.9 A study has shown that women with RA who had severe disease had worse pregnancy outcomes (ie, preterm delivery and small for gestational age infants) than those who had mild or no disease.10 Furthermore, approximately 40% of women with RA flare within 6 months postpartum.11
1. Lipsky PE. Rheumatoid arthritis. In: Fauci AS, Langford CA, eds. Harrison’s Rheumatology. 2nd ed. New York, NY: McGraw-Hill Medical; 2010:82-99.
2. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205-2219.
3. Arthritis-related statistics. Centers for Disease Control and Prevention website. http://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm. Accessed May 31, 2016.
4. Suresh E. Diagnosis of early rheumatoid arthritis: what the non-specialist needs to know. J R Soc Med. 2004;97(9):421-424.
5. Taylor PC, Moore A, Vasilescu R, Alvir J, Tarallo M. A structured literature review of the burden of illness and unmet needs in patients with rheumatoid arthritis: a current perspective. Rheumatol Int. 2016;36(5):685-695.
6. Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum. 2010;62(6):1576-1582.
7. Matcham F, Scott IC, Rayner L, et al. The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum. 2014;44(2):123-130.
8. Dowdy SW, Dwyer KA, Smith CA, Wallston KA. Gender and psychological well-being of persons with rheumatoid arthritis. Arthritis Care Res. 1996;9(6):449-456.
9. Nelson JL, Ostensen M. Pregnancy and rheumatoid arthritis. Rheum Dis Clin North Am. 1997;23(1):195-212.
10. Bharti B, Lee SJ, Lindsay SP, et al. Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. J Rheumatol. 2015;42(8):1376-1382.
11. de Man YA, Dolhain RJ, van de Geijn FE, Willemsen SP, Hazes JM. Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. Arthritis Rheum. 2008;59(9):1241-1248.
Rheumatoid arthritis (RA) is a chronic, progressive, inflammatory, autoimmune disease affecting an estimated 1,500,000 adults in the United States.1-3