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Rheumatoid Arthritis — Internal Medicine Management

Systemic management of a chronic autoimmune inflammatory disease of the joints.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Rheumatoid Arthritis — Internal Medicine Management?

Rheumatoid arthritis (RA) is an autoimmune disease characterised by chronic inflammation of the synovial membrane and symmetrical polyarthritis. It preferentially involves the small joints (metacarpophalangeal and proximal interphalangeal joints, the wrist). Rheumatoid factor (RF) and anti-CCP antibodies are the serological markers used for diagnosis.

Early diagnosis and treatment (within the first 3–6 months — the so-called window of opportunity) are critical to prevent joint erosion and destruction. A treat-to-target strategy is used to aim for remission or low disease activity.

Extra-articular involvement (interstitial lung disease, vasculitis, Felty's syndrome, rheumatoid nodules, cardiovascular disease) increases both morbidity and mortality. Cardiovascular risk is 1.5–2 times higher in patients with RA than in the general population.

Symptoms

Symmetrical joint pain and swelling (particularly of the hands and wrists)
Morning stiffness lasting more than 30 minutes
Fatigue and malaise
Rheumatoid nodules (at the elbows and fingers)
Restricted movement
Extra-articular features (lung, eye and vascular involvement)

Risk Factors

Female sex (3:1 ratio)
A family history of rheumatoid arthritis
Smoking (the strongest environmental risk factor)
HLA-DRB1 shared epitope
Periodontal disease (P. gingivalis)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When symmetrical joint swelling and morning stiffness appear
  • When joint symptoms last more than six weeks
  • When RF or anti-CCP antibodies are positive
  • When disease activity cannot be controlled on current treatment

Treatment Methods

01
Methotrexate (the first-line conventional synthetic DMARD — the cornerstone of treatment)
02
Leflunomide or sulfasalazine when methotrexate is contraindicated
03
Biologic DMARDs (anti-TNF, tocilizumab, abatacept, rituximab)
04
JAK inhibitors (tofacitinib, baricitinib, upadacitinib)
05
Short-course bridging corticosteroids during flares
06
Cardiovascular risk management

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.