Date:27/12/2008 URL: http://www.thehindu.com/2008/12/27/stories/2008122757900400.htm

New Delhi

New treatment guidelines for rheumatoid arthritis

Staff Reporter

Aims to relieve pain and swelling of the joints

NEW DELHI: Rheumatologists from all over the country under the banner of Indian Association of Rheumatology have chalked out new treatment guidelines for rheumatoid arthritis, a chronic and debilitating inflammatory disease that affects an estimated 10 million Indians.

The need for new guidelines was felt because of a paradigm shift since the first guidelines were published in 2002. The treatment now is aimed at induction of remission and maintenance of tight control through use of conventional and new biological disease-modifying anti-rheumatoid drugs.

The new guidelines are intended to guide practising physicians, rheumatologists and clinical immunologists in managing patients with rheumatoid arthritis.

The guidelines are expected to ensure uniformity in assessment and treatment and achieve the fundamental purpose of treatment: to relieve pain and swelling of the joints so that cartilage and bone loss can be minimised enabling an improvement in the functional quality of life.

Rheumatoid arthritis is a systemic disease -- an autoimmune disorder in which the body’s defence system attacks the joints.

The most visible symptoms of rheumatoid arthritis are swollen joints and crippling stiffness, particularly of the hands and feet. It causes pain, swelling, stiffness, loss of function in the joints. It also causes fatigue, fever and loss of appetite.

While diagnosis of rheumatoid arthritis in the early stages is difficult, the objective of the new guidelines is to establish a standard protocol for treatment and management of the disease, say experts.

The guidelines are meant to help doctors in assessment of disease activity and damage, categorisation of patients and emphasis on education and counselling of patients on the disease condition.

Meanwhile, speakers and participants at a recent conference were unanimous in their view that successful management of the disease conditions in patients with rheumatoid arthritis depends on empowering them with knowledge about the chronic and fluctuating course of the disease, side-effects, cost of the drugs and the need for continual physiotherapy.