Rheumatoid arthritis affects people differently. How quickly it has developed, how it responds to treatment and how advanced it is at the time of diagnosis all affect its likely course. In general, however, there are three main outcomes:

Persistent mild disease
Around 20% of people with rheumatoid arthritis have mild symptoms that have little impact on their daily life and don’t progress much.

Gradual progression
Most people with rheumatoid arthritis – around 75% – experience a gradual progression of the disease. It usually follows a pattern of stable disease, where there may be few symptoms and which may last months or years, with intermittent flare-ups when the inflammation suddenly increases, causing a deterioration in symptoms. Some people may find there are particular triggers for their flare-ups.

Severe disease
A minority of people with rheumatoid arthritis – only around 1 in 20 – suffer from severe, rapidly progressing disease that seriously limits their daily lives.

People with severe symptoms at the time of diagnosis, non-joint symptoms, positive rheumatoid factor, positive anti-CCP, high inflammatory markers or a family history of rheumatoid arthritis are likely to have more severe disease than those without. However, early treatment with DMARDs can slow down or even prevent the progression of the disease.

Current research

Rheumatoid arthritis is an active area of research. Current research projects include:

• discovering the exact cause of rheumatoid arthritis in order to find a cure for the disease
• identifying new targets for medicines, such as particular types of immune cells or inflammatory chemicals
• using gene therapy to stimulate the body to produce natural anti-inflammatory chemicals
• finding a way to target treatment to the affected joints, without affecting the rest of the body
• using genetic testing to predict which patients will respond to which medications

Links

The following organisations and websites provide useful information on rheumatoid arthritis.

• American College of Rheumatology www.rheumatology.org
• Arthritis Care www.arthritiscare.org.uk
• Arthritis Foundation www.arthritis.org
• Arthritis Insight www.arthritisinsight.com
• Arthritis New Zealand www.arthritis.org.nz
• British Society for Rheumatology www.rheumatology.org.uk
• European Rheumatism and Arthritis Surgical Society www.erass.org
• Johns Hopkins Arthritis Center www.hopkins-arthritis.org
• National Institute of Arthritis and Musculoskeletal and Skin Diseases www.niams.nih.gov
• National Rheumatoid Arthritis Society www.rheumatoid.org.uk
• Rheumatoid Arthritis Australia www.rheumatoidarthritis.com.au
• The Arthritis Research Campaign www.arc.org.uk

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