SCIN130: Introduction to Biology with Lab - The Outline Student Name and Section Number Assignment 2 Outline: Rheumatoid Arthritis Introduction Reason for selecting topic It is a common problem ...

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SCIN130: Introduction to Biology with Lab - The Outline
Student Name and Section Number
Assignment 2 Outline: Rheumatoid Arthritis
Introduction
Reason for selecting topic
It is a common problem that affects a large number of people and their wellbeing
I have witnessed it first hand through some of my elderly relatives
There is a need to create awareness of the condition and best strategies to deal with it
Definition of Rheumatoid Arthritis (RA)
Rheumatoid Arthritis is an autoimmune and inflammatory disease
Body immune system attacks healthy cells (National Health Services, 2022)
It mostly affects the joints beginning with the lining of the joints
History of RA
Likely to have been identified 300s B.C.by Hippocrates
In AD 123 Indian medical tests show abnormalities similar to RA
First studies in 1800s
RA distinguished from other arthritis 1859 (Deane & Holers, 2019)
American College of Rheumatology formed 1934
RA distinguished as a condition 1940
Image
An elderly woman with hand joints deformed due to rheumatoid arthritis

(Image credit: My Emerald Health)
Content Section
Statistics and Epidemiology
RA I the most common form of autoimmune arthritis (American College of Rheumatology)
Global prevalence of RA is between 0.5% to 1% of the population in developed countries (England & Mikuls, 2020)
In developing countries such as those in Africa and Middle East, it ranges between 0.06% and 3.4%.
More than 1.3 million people in the USA have RA
It represents almost 1% of the whole population
RA is more common in women than in men
It can lead to a range of poor long term outcomes which are however reduced with the use of aggressive treatment strategies
RA is ore prevalent in some populations more than others e.g. Pima Native Americans have a 10 times higher rate of getting the disease than most other populations (Helget et al., 2021)
Costs
Direct costs
Medication costs- DMARDs costs the patients between $1,500 and $2000 each year depending on the prescribed medication
Biologics as a new type of RA treatment costs patients between $1,300 and $3000 per month
Surgery in addition to medication is also expensive. For instance knee replacements could cost over $30, 249
Payments for assistive devices, physical therapy after surgeries are additional cost burdens to patients and their families
Annual direct costs for rheumatoid arthritis (RA) patients are estimated to range from $12,509-$36,053
Indirect cots
Osteoarthritis and rheumatoid arthritis costs the National Health Service Money is lost when a patient productivity is reduced
Lost wages, absenteeism can cost between $1,500 and $22,000 a year per patient
Increases the costs of Medicare as RA patients pay more than those without the condition
As of 2013 the total cost of arthritis attributed conditions cost the government $303.5 billion due to medical costs and lost earnings (Center for Disease Control and Prevention, 2020)
The figure as of today could have ballooned to double due to increasing costs of care and prevalence of the disease
Anatomy & Physiology and Etiology
Involves the breakdown of structures of the joint, particularly cartilage
 Characterized by the presence of autoantibodies known as rheumatoid factors (RF) and anti-citrullinated peptide antibodies
Leads to pain stiffness, and joint deformities
Causes of the diseases yet to be known
Combination of hormonal, genetic and environmental factors are likely attributed to the disease
Diagnosis/Treatment/Prognosis
Diagnosis of RA
There are no blood tests or physical findings that can con firm the diagnosis in early stages
ESR and CRP levels also used to test rheumatoid arthritis that help to indicate inflammatory processes in the body
X-rays help track the progression of the disease. MRI and ultrasounds can help judge severity of disease
Treatment of RA
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.
Steroids-Corticosteroid medications, such as prednisone, reduce inflammation
Conventional DMARDs-These drugs can slow the progression of RA
Targeted synthetic DMARDs such as Baricitinib (Olumiant), and tofacitinib used after others fail
The use of biological agents also known as biological response modifiers
Therapy
Doctor may refer one to a physician or occupational therapists
Doctor refer to assistive devices
Surgery
Synovectomy -Surgery to remove the inflamed lining of the joint 
Surgeon may be able to repair the tendons around your joint
Joint fusion to stabilize or realign joint to relief pain
Total joint replacement-damaged parts are removed and a prosthesis inserted
Prognosis of RA
RA causes 80% to 85% joint damage in patients
Most damage occurs after 2 years of the disease
Mortality risk increases when disease is untreated
Individuals with untreated RA are twice likely to die compared to those that do not have the condition
RA reduces life expectancy by as much as 10 to 15 years
Conclusion
Rheumatoid Arthritis is an autoimmune and inflammatory disease where the body immune system attacks healthy cells
First studies on RA were as early as the 1800s with it being distinguished from other arthritis in 1940s
It causes deformity in the joints of a patient
Annual direct costs for rheumatoid arthritis (RA) patients are estimated to range from $12,509-$36,053
The condition is diagnosed through physical examination and x-rays and treatment include the use of medication, therapy or surgery
Lack of treatment leads to increased mortality reducing life expectancy by over 10 years
References
Centers for Disease Control and Prevention. (2020, March 2). Cost statistics: The Cost of Arthritis in US Adults. https://www.cdc.gov/arthritis/data_statistics/cost.htmDeane, K. D., & Holers, V. M. (2019). The natural history of rheumatoid arthritis. Clinical therapeutics, 41(7), 1256-1269. https://doi.org/10.1016/j.clinthera.2019.04.028
England, B. R., & Mikuls, T. R. (2020). Epidemiology of, risk factors for, and possible causes of rheumatoid arthritis. URL: https://www.uptodate.com/contents/epidemiology-of-risk-factors-for-and-possible-causes-of-rheumatoid-arthritisHelget, L. N., England, B. R., Roul, P., Sayles, H., Petro, A. D., Michaud, K., & Mikuls, T. R. (2021). Incidence, prevalence, and burden of gout in the Veterans Health Administration. Arthritis care & research, 73(9), 1363-1371. https://doi.org/10.1002/acr.24339National Health Services. (2022). Rheumatoid Arthritis. https://www.nhs.uk/conditions/rheumatoid-arthritis/