Rheumatoid arthritis

Rheumatoid arthritis (often called RA) is a chronic(long-standing) disease that damages the joints of the body.

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INTRODUCTION• Rheumatoid arthritis affects approximately 1% of

world population, with women developing the condition three times more than men.

• Juvenile rheumatoid arthritis (JRA) causes joint inflammation and stiffness for more than six weeks in a child aged 16 or younger.

• Even though infectious agents such as viruses, bacteria, and fungi have long been suspected, the cause of rheumatoid arthritis is unknown.

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An example showing the differences between a normal, healthy joint, a joint affected by osteoarthritis, and one affected by rheumatoid arthritis.

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Signs and symptoms•The symptoms of rheumatoid arthritis come and go, depending on the degree of tissue inflammation.

•Symptoms can include fatigue, lackof appetite, low-grade fever, muscle and joint aches, and stiffness.

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Diagnosis

Blood test X-ray

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TREATMENT•Two classes of medications are used in treating rheumatoid arthritis:

1.fast-acting "first-line drugs" and

2.slow-acting "second-line drugs.“

•Symptomatic pain relief can often be achieved with oral acetaminophen (Tylenol and others) or OTC topical preparations.

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The areas of the body, other than the joints, that are affected by rheumatoid inflammation are treated individually.

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MARKET SHARE OF DIFFERENT CLASSES

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OVERALL MARKET SHARE OF DRUGS

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SURVEY NSAIDs

DRUGS BRANDS STARS

Hydroxychloroquine

HYDROCAB **

ACETYLSALICYL-ATE

ACE-PROXYVON

***

NAPROXEN NAPROSYN *

IBUPROFEN ABUFEN-C *

ETODOLAC ETOLOR *

PARACETAMOL CALPOL ****

DICLOFENAC MISONAC **

CELECOXIB CELEDOL *

D-PENICILLAMINE CILAMIN *

AURANOFIN AUROCRIS *

Immunosuppressive drugs

DRUGS BRANDS STARS

Azathioprine

imuran *

Cyclophosphamide

cycloxan *

chlorambucil

leukeran *

cyclosporin

Sandimmune neoral

*

methotrexate

folitrax ***corticosteroids

DRUGS BRANDS STARS

prednisolone

wysolone

***11

1.http://kidshealth.org/parent/general/body_basics/bones_muscles_joints.html. assessed on 17/9/09.

2. Majithia V, Geraci SA (2007). "Rheumatoid arthritis: diagnosis and management". page no: 936–9. 3. Landré-Beauvais AJ (1800). La goutte asthénique primitive (doctoral thesis). Paris. "The first

description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800". Joint Bone Spine 68 (2): 130–43.

4. Turesson C, O'Fallon WM, Crowson CS, Gabriel SE, Matteson EL (2003). "Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years". page no: 722–7.

5. Westwood OM, Nelson PN, Hay FC (April 2006). "Rheumatoid factors: what's new?". Rheumatology (Oxford) page no: 379–85.

6. Nishimura K, Sugiyama D, Kogata Y, et al (June 2007). "Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis" page no:797–808.

7. Arnett F, Edworthy S, Bloch D, McShane D, Fries J, Cooper N, Healey L, Kaplan S, Liang M, Luthra H (1988). "The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.". Arthritis Rheum page no: 315–24.

8.O'Dell J (2004). "Therapeutic strategies for rheumatoid arthritis.". N Engl J Med page no : 2591–602.

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9.Hasler P (June 2006). "Biological therapies directed against cells in autoimmune disease.". Springer Semin Immunopathol page no:443–56.

10. Vital E, Emery P (Sep 15 2005). "Advances in the treatment of early rheumatoid arthritis.".page no: 1002, 1004.

11.http://www.fda.gov/Drugs/ResourcesForYou/HealthProfessionals/ucm107046.htm assessed on

12. Edwards J, Szczepanski L, Szechinski J, Filipowicz-Sosnowska A, Emery P, Close D, Stevens R, Shaw T (2004). "Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis.".page no: 2572–81.

13. Fresenius HemoCare, Inc., "New Hope for Rheumatoid Arthritis Patients," press release, September 17, 1999.

14.Hart FD (March 1976). "History of the treatment of rheumatoid arthritis".page no: 763–5. 15. Franke A, Reiner L, Pratzel HG, Franke T, Resch KL (August 2000). "Long-term efficacy of radon

spa therapy in rheumatoid arthritis--a randomized, sham-controlled study and follow-up". Page no:894–902..

16.S. Wright, M. Ware and G. Guy (2006). "The use of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis )".page no: 781.

17. http://www.ayurveda-herbal-remedy.com/discover-ayurveda/amavata.html 18. http://holisticonline.com/Remedies/Arthritis/arth_RA_homeopathy.htm

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