Rheumatoid Arthritis

Feeling pain and stiffness in joints becoming swollen from time to time might be the first sign of a disease called Rheumatoid Arthritis (RA), caused by an uncontrolled immune response.

Although medical treatment strategies together with physical activity (‘low impact activities’ such as swimming, walking, stretching with physiotherapist) exist to relieve pain, and the disease can go to remission phases with no or few symptoms, neither a cure is available yet, nor precise knowledge on the reason why the immune system starts attacking one’s own body.

The way of prevention is also mainly empirical, but several risk factors, such as cigarette smoking, or exposure to certain dusts have been identified. It is also important to mention that women are diagnosed two to three times more often than men, but men tend to have more severe symptoms.

How is RA diagnosed?

There is no single test available for diagnosis, but based on the symptoms together with blood tests and imaging studies (such as X-ray, or ultrasound and magnetic resonance imaging (MRI)) provide sufficient information to doctors. Only a doctor can tell if you have arthritis or a related condition, and what to do about it.

Currently routine blood tests are used to support the diagnosis, from which the presence of certain factors (such as the so-called rheumatoid factor (RF), the cyclic citrullinated protein antibody (anti-CCP), the antinuclear antibody (ANA), or the C-reactive protein (CRP) levels). However, these tests are not specific enough to RA. They also do not necessarily reflect whether a patient is responding well enough to medication following an established diagnosis.

MDQuest’s blood test employing a novel diagnostic approach, called MDQ (MultiDrugQuant™), which is a great addition to the standard tests, alerting doctors at an early stage, if the routinely used first-line medications are not proving to be effective enough to control the disease, allowing for alternative prescribed medication choices to be made in a more time effective manner.

How is RA treated?

The major goal of treatment in RA is to control the disease and achieve remission, i.e. to stop further destruction caused by the harmful immune process. Besides medication, physical activity and relaxing are also beneficial.

Following international recommendations, the doctor will prescribe disease-modifying antirheumatic drugs (DMARDs) first, and will recommend rest and strengthening exercise to slow down or stop the immune system from attacking the joints. If reasonable, nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarials or corticosteroids are also prescribed together with DMARDs.

If the above medication strategy is noted to cause serious side effects, or the treatment tends to be ineffective, biological drugs will be prescribed instead. These drugs are designed to interfere with the immune system’s ability to launch the damaging inflammatory process.

If the disease symptoms reach a high severity, surgery may be needed to replace destroyed joints.

How can the patient’s condition and response to therapy be monitored?

In practice, disease severity, medication response and side effects should be frequently monitored by the doctor.

Since currently no objective routine diagnostics is available to monitor the disease status, doctors primarily rely on a scoring system called 'disease activity scores' (DAS28). This, however, is partly subjective, and is supplemented by the previously mentioned blood and imaging tests.

The novel MDQ diagnostic test measures a functional signal of the immune cells, and thus provides objective values describing disease activity. If performed in regular intervals following the diagnosis, it is a suitable tool to monitor the effectiveness of your treatment, and to determine the optimal time for introducing new medication, allowing your doctor to tailor your therapy on a personal level.

References and Further Sources







The information provided here is only for general informational purposes, and does not provide medical advice. If you think you may have a medical emergency, immediately call your doctor or dial your regional emergency number.