Autoimmune Disease

Rheumatoid Arthritis

RA — A chronic, systemic inflammatory joint disorder

Overview

What is Rheumatoid Arthritis?

Rheumatoid Arthritis is a chronic, systemic autoimmune disease primarily targeting the synovial joints. The immune system mistakenly attacks the synovium — the lining of the joint capsule — leading to pannus formation, cartilage erosion, and progressive joint destruction. RA is characterised by symmetrical peripheral joint inflammation, morning stiffness lasting more than one hour, and systemic extra-articular manifestations. It is associated with significant morbidity, cardiovascular risk, and reduced life expectancy if inadequately treated.

Clinical Presentation

Signs & Symptoms

Symptoms are typically symmetrical and involve small joints of the hands and feet first, progressing to larger joints.

Currently Licensed States:

Systemic Involvement

Organs Affected

Cardiovascular

Pericarditis, accelerated atherosclerosis, increased MI risk

Pulmonary

Pleuritis, pneumonitis, pulmonary hypertension

Ocular

Episcleritis, scleritis, keratoconjunctivitis sicca

Haematological

Anaemia of chronic disease, Felty syndrome

Diagnosis

ACR/EULAR 2010 Criteria

Score ≥6/10 confirms RA. Applies to patients with at least 1 swollen joint not explained by another disease.

Laboratory & Imaging

Key Investigations

Pathophysiology

Disease Mechanism

1


Genetic susceptibility

HLA-DR2/DR3, complement deficiencies (C1q, C4), IRF5, STAT4 gene polymorphisms increase risk.

2


Triggering factors

UV light, infections (EBV), hormonal changes, and drugs (procainamide, hydralazine) can precipitate disease.

3


Autoantibody formation

B cells produce ANA, anti-dsDNA, and other autoantibodies. T helper cells and type I interferons amplify the response.

4


Immune complex deposition

Autoantibody-antigen complexes deposit in tissues — kidneys, skin, vessels — activating complement and causing inflammation.

5


End-organ damage

Persistent inflammation leads to fibrosis and functional impairment of target organs if disease remains uncontrolled.

Ready to Take the First Step?

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