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Arthritis

A general term for conditions that cause inflammation (swelling) of the joints and surrounding tissues. Some forms of arthritis may occur simultaneously with osteoporosis and Paget's disease.

PubMed Health Glossary
(Source: NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases)

About Arthritis

Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA) is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or small joints of the hands. OA usually develops in joints that are injured by repeated overuse from performing a particular task or playing a favorite sport or from carrying around excess body weight.

Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint. As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom of OA is pain that worsens following exercise or immobility.

Treatment usually includes analgesics, topical creams, or nonsteroidal anti-inflammatory drugs (known as NSAIDs); appropriate exercises or physical therapy; joint splinting; or joint replacement surgery for seriously damaged larger joints, such as the knee or hip.

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that usually involves various joints in the fingers, thumbs, wrists, elbows, shoulders, knees, feet, and ankles. An autoimmune disease is one in which the body releases enzymes that attack its own healthy tissues. In RA, these enzymes destroy the linings of joints. This causes pain, swelling, stiffness, malformation, and reduced movement and function.

People with RA also may have systemic symptoms, such as fatigue, fever, weight loss, eye inflammation, anemia, subcutaneous nodules (bumps under the skin), or pleurisy (a lung inflammation).

Although osteoporosis and osteoarthritis are two very different medical conditions with little in common, the similarity of their names causes great confusion. These conditions develop differently, have different symptoms, are diagnosed differently, and are treated differently. NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

Biologics for Early Rheumatoid Arthritis: Review of Health Economic Studies [Internet]

It is estimated that 20,000-30,000 people in Norway suffer from the disease. Due to the patients’ reduced functional capacity, costs are incurred by employers, relatives and not least the patients themselves. Research has shown that early treatment with biologic drugs may be beneficial. Biologics are however more costly than conventional DMARDs, and Norwegian guidelines therefore stipulate that at least one DMARD should be attempted before treatment with biologic drugs is initiated. The Norwegian Knowledge Centre for the Health Services has reviewed the literature on the cost-effectiveness of biologic treatment for early RA as part of a project commissioned by the commissioned by the Norwegian Rheumatism Association.

Antimalarials for treating rheumatoid arthritis

Antimalarials have been used for the treatment of rheumatoid arthritis (RA) for several decades. This review found four trials, with 300 patients receiving hydrochloroquine and 292 receiving placebo. A benefit was observed in the patients taking hydroxychloroquine compared to placebo. There was no difference between the two groups in terms of those who had to withdraw from trials due to side effects.

Paracetamol versus nonsteroidal anti‐inflammatory drugs for rheumatoid arthritis

In rheumatoid arthritis (RA), the joints are swollen, stiff and painful. Nonsteroidal anti‐inflammatory drugs (NSAIDs) such as ibuprofen are often recommended to ease the pain and swelling in the joints. Paracetamol (also known as acetaminophen) is another type of medication to relieve pain in RA.

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Summaries for consumers

Baricitinib (Olumiant) in the treatment of rheumatoid arthritis: Baricitinib (Olumiant) for rheumatoid arthritis after treatment with several conventional DMARDs

In 2017, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of baricitinib (trade name: Olumiant) for adults who have had treatment with several conventional DMARDs that weren’t effective enough. The manufacturer gave IQWiG one relevant study that provided preliminary answers to a number of questions. The researchers at IQWiG analyzed data from 294 patients. Of these, 170 had treatment with baricitinib and 124 had the standard treatment with adalimumab. All of the participants received treatment with methotrexate as well. The study lasted about one year. The following results apply to people with moderate to severe rheumatoid arthritis who have had treatment with several conventional disease-modifying anti-rheumatic drugs (DMARDs) that weren’t effective enough.

Tofacitinib (Xeljanz) for the treatment of rheumatoid arthritis: Tofacitinib (Xeljanz) for rheumatoid arthritis after treatment with several conventional DMARDs.

In 2017, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of tofacitinib (trade name: Xeljanz) in adults who have had treatment with several conventional DMARDs that weren’t effective enough. The manufacturer gave IQWiG one relevant study which provides preliminary answers to a number of questions. The researchers at IQWiG analyzed data from 206 patients. Half of the participants had treatment with tofacitinib, the other half had treatment with the standard drug adalimumab. All of the participants received treatment with methotrexate as well. The study lasted about one year. The following results apply to people with moderate to severe rheumatoid arthritis who have had treatment with several conventional disease-modifying anti-rheumatic drugs (DMARDs) that weren’t effective enough.

Baricitinib (Olumiant) in the treatment of rheumatoid arthritis: Baricitinib (Olumiant) for rheumatoid arthritis after treatment with a single conventional DMARD

In 2017, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of baricitinib (trade name: Olumiant) in people with rheumatoid arthritis that is expected to quickly get worse. The manufacturer gave IQWiG one relevant study which provides preliminary answers to a number of questions. The researchers at IQWiG analyzed data from 396 patients. Of these, 243 had treatment with baricitinib and 153 had treatment with the biological drug adalimumab. All of the participants received methotrexate as well. The study lasted about one year. The following results apply to people with moderate to severe rheumatoid arthritis who have had treatment with methotrexate that was not effective enough on its own.

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Terms to know

Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Joints
In medicine, the place where two or more bones are connected. Examples include the shoulder, elbow, knee, and jaw.
Osteoporosis
Literally means "porous bone." This disease is characterized by too little bone formation, excessive bone loss, or a combination of both, leading to bone fragility and an increased risk of fractures of the hip, spine and wrist.
Paget Disease
A bone disease that causes bones to grow larger and weaker than normal.
Rheumatologist
Doctors who diagnose and treat diseases of the bones, joints, muscles, and tendons, including arthritis and collagen diseases.
Tissue
A group of cells that act together to carry out a specific function in the body. Examples include muscle tissue, nervous system tissue (including the brain, spinal cord, and nerves), and connective tissue (including ligaments, tendons, bones, and fat). Organs are made up of tissues.

More about Arthritis

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See Also: Psoriatic Arthritis, Osteoarthritis, Rheumatoid Arthritis, Reactive Arthritis, Juvenile Arthritis

Other terms to know: See all 6
Inflammation, Joints, Osteoporosis

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