Review on Rheumatoid Arthritis

Abstract

A chronic, systemic inflammatory disease that mostly affects synovial joints, rheumatoid arthritis (RA) causes gradual joint degeneration, deformity, and disability. Systemic symptoms, autoantibody production, and chronic synovial inflammation are its defining characteristics. Its development and progression are influenced by immunological, environmental, and genetic variables, albeit the precise aetiology is yet unclear. Millions of people are impacted by the illness globally, particularly women, and it has a major negative influence on quality of life. Results have improved with early diagnosis and vigorous therapy with biologics and disease-modifying anti rheumatic medications (DMARDs). However, there are still issues with managing extra-articular problems, personalised therapy, and illness prognosis. Future improvements in illness management and perhaps remission are possible with ongoing research into immunological mechanisms and targeted medicines.

Introduction

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease primarily affecting synovial joints, characterized by prolonged inflammation, joint pain, stiffness (especially morning stiffness), and autoantibody production (e.g., rheumatoid factor and anti-citrullinated protein antibodies). It affects about 0.5–1% of the global population, with women being two to three times more likely to develop the disease, typically between ages 30 and 60. RA differs from osteoarthritis by involving multiple organs beyond joints, including skin, eyes, lungs, and cardiovascular system.

The disease results from a complex interplay of genetic factors (notably HLA-DR1 and HLA-DR4 alleles), environmental triggers (smoking, infections, microbiome imbalances), and immune system dysregulation. This causes chronic synovitis mediated by immune cells and pro-inflammatory cytokines like TNF-α, IL-1, and IL-6, leading to joint damage and systemic symptoms.

Diagnosis relies on clinical signs, serological markers, and imaging modalities, guided by ACR/EULAR classification criteria. Early diagnosis and treatment are critical to prevent irreversible joint damage. Treatment includes disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate, biologics targeting specific cytokines or immune cells, and newer oral Janus kinase inhibitors. NSAIDs and corticosteroids help manage symptoms but do not alter disease progression. A "treat-to-target" approach aiming for remission or low disease activity, combined with lifestyle changes and patient education, improves outcomes.

Risk factors include genetics, female sex, smoking, infections, hormonal influences, and environmental exposures. RA also associates with comorbidities like cardiovascular disease and osteoporosis.

Future research focuses on precision medicine tailored to genetic and molecular profiles, exploring gut microbiota roles, immunotherapies, and safer treatments. Complementary therapies and multidisciplinary care models are also under study to enhance quality of life and manage the global RA burden.

Conclusion

Rheumatoid arthritis is still a crippling and complicated autoimmune disease that has a significant impact on joint integrity and general health. Prognosis and patient care have been greatly improved by developments in immunology and treatment approaches. Even with these advancements, better results still depend on early diagnosis, tailored therapy, and a deeper comprehension of disease causes. Effective illness management requires a multidisciplinary strategy that includes medication, lifestyle changes, and rehabilitation. Predictive biomarkers, less immunosuppressive therapies, and possible curative measures should be the main topics of future study. The burden of RA can be lessened with ongoing innovation and clinical attention, providing hope for a longer-lasting remission and an enhanced quality of life.

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Copyright

Copyright © 2025 Mr. Shubham Mahajan, Ms. Pooja Gaikwad, Mr. Nitin Gawai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.