New Method to Detect Heart Disease in RA Patients
Women, Rheumatoid Arthritis, and Mortality Rates: New Study, New Answers
Rheumatoid Arthritis 101
Rheumatoid arthritis (RA) is a well-recognized form of inflammatory arthritis, and its incidence is on the rise. Researchers don't know the exact cause of RA, and there's no cure.
RA can also affect any organ in the body. From skin ulcers, to lung disease, to eye vessel damage, and potentially increasing susceptibility to malignancies — RA can exert a large burden of inflammation systemically.
RA is also two to three times more common in women than men, according to the Center for Disease Control and Prevention.
New Research on Women and RA
In a recent , researchers found that mortality rates are two times higher in postmenopausal women with RA and the RA-specific antibodies, anti-cyclic citrullinated peptide (anti-CCP).
Death rates over ten years were found to be higher for women with RA, according to the study. In particular, the group with anti-CCP positivity had 2 to 2.5 fold increase in mortality rates.
Furthermore, known risks such as tobacco use, lack of physical activity, and diabetes, in association with a positive anti-CCP, were found to be associated with significantly higher mortality rates.
Researchers evaluated data from the Women’s Health Initiative, which enrolled over 160,000 women from 1993 to 1997. They focused on individuals who had self-reported RA — approximately 10,000 women.
In this group, they separated probable RA cases, defined as anti-CCP positive with or without disease modifying anti-rheumatic medication (DMARD) use vs anti-CCP with DMARD use.
They deemed the self-reported women with RA, who were anti-CCP negative and not on DMARDS, as not having RA. Blood samples from these patients were used to evaluate for several antibodies, which can be seen in rheumatoid arthritis patients, including rheumatoid factor antibody (RF) and anti-CCP antibodies.
What’s Antibodies Got to Do With It?
Antibodies have the all-important role of detecting foreign invaders in our bodies and neutralizing them. Pathogenic antibodies can occur when the immune system mistakenly begins to attack the body, hence causing autoimmune disease.
RF antibody and anti-CCP are two common culprits found in people with RA. These can orchestrate quite a number, destroying joints without flinching.
Not So Fast — Study Limitations
Ultimately, exact biochemical pathways contributing to the pathogenecity of anti-CCP molecules need to be worked out. However, it is generally agreed upon that many adverse effects of RA, including increased risk of heart disease and mortality has to do with widespread systemic inflammation that is out of control.
The newer and growing numbers of immunosuppressive medications now on the market were generally not available during the time of the Women’s Health Initiative. Therefore, it would be interesting to see the overall effects of these newer, more potent medications on overall mortality in RA patients.
So, what’s the point?
RA and You
Overall, growing evidence demonstrates increased morbidity and mortality with long-standing uncontrolled rheumatoid arthritis.
Therefore, if you have this disease, it is in your best interest to work with your rheumatologist and use their medication arsenal to put out the inflammatory fire as soon as possible. Remember, the goal is remission and fast.
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