KUALA LUMPUR, Jan 22 (Bernama) -- Five out of every 1,000 Malaysians are affected by Rheumatoid Arthritis (RA), a condition that causes chronic autoimmune joint pain, with women said to be two to three times more at risk than men.
Consultant Rheumatologist at Sunway Medical Centre (SMC), Sunway City, Dr Cheah Chee Ken said Many people mistakenly assume that joint pain is simply a natural part of ageing, often overlooking RA as a potential cause.
He said RA is a chronic autoimmune disease that can affect individuals at any age, not just older adults.
“It is influenced by epigenetic, hormonal, reproductive, and neuroendocrine factors, as well as environmental and lifestyle factors such as smoking, exposure to cigarette smoke, poor oral hygiene habits, chronic periodontitis, gum infections, and many more.
"Individuals with a genetic predisposition or those who have experienced physical trauma, such as a car accident, may be more prone to abnormal immune activity, causing inflammation in the joint lining, known as the synovium. This inflammation can trigger symptoms such as joint pain, swelling and stiffness in the morning.
“RA can happen to anyone regardless of age, but it most often occurs to those between the ages of 30 and 50. In addition, smokers and individuals who are obese have a higher risk of getting RA and tend to respond less effectively to treatment," he said in a statement issued by SMC today.
Dr Cheah said there is currently no cure for RA and patients require lifelong management including medication, physical therapy and sometimes surgery to replace knees and hips.
He said if RA patients are not managed well, it can cause irreversible complications, as well as affecting the joints and other parts of the body such as the lungs, heart, eyes, and even the spine, which can cause mobility problems.
More worryingly, he said, the unpredictable nature of RA including flare-ups can potentially cause patients to experience a long-term disability that can affect psychology.
"Patients and their families often face mental health challenges like anxiety or depression and need emotional support, as well as education to better understand and manage RA.
"There are also support groups such as the Arthritis Foundation Malaysia (AFM) that offer an important support network where individuals can share experiences, practical advice, and encouragement, thereby helping them overcome the physical and emotional burden of facing this condition," he said.
According to Dr Cheah, the diagnosis of RA is challenging due to the lack of certain tests, making the process more complex, especially identifying the early signs and symptoms of RA that often resemble other diseases, leading to delays and difficulties in making an accurate diagnosis.
However, he said, SMC has developed a combination of approaches starting with a detailed patient history that includes the onset of symptoms, disease progression and any RA-related symptoms, followed by a physical examination to detect signs typical of the condition such as joint pain, swelling, stiffness or limited movement.
In addition, musculoskeletal ultrasound imaging will also be performed to identify inflammation, joint damage, the condition of the synovial layer and the presence of joint effusion, he said.
Dr Cheah said that in the early stages of RA, patients will usually be given anti-inflammatory drugs, either non-steroidal pain relievers or steroid treatment to suppress inflammation quickly.
"To modify the progression of RA, disease-modifying antirheumatic drugs (DMARDs) are essential, which can be classified as conventional synthetic DMARDs or biologic DMARDs,” he said.
He said patients diagnosed early often respond better to conventional synthetic DMARDs, whereas adjustments may be needed for those who do not respond well to treatment.
“This can include advanced therapies like biologic DMARDs and oral small molecules. These advanced therapies target specific inflammatory molecules involved in RA activity, offering improved efficacy and fewer side effects compared to traditional treatments,” he added.
-- BERNAMA
