Kuala Lumpur: 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, highlighted that many people mistakenly assume joint pain is simply a natural part of ageing, often overlooking RA as a potential cause.
According to BERNAMA News Agency, Dr Cheah explained that 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, and chronic periodontitis. He emphasized that individuals with a genetic predisposition or those who have experienced physical trauma 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 morning stiffness.
Dr Cheah noted that RA most often occurs between the ages of 30 and 50. Additionally, smokers and individuals who are obese face a higher risk and tend to respond less effectively to treatment. He highlighted that there is no cure for RA, and patients require lifelong management, including medication, physical therapy, and sometimes surgery.
He further warned that if RA patients are not well-managed, it can cause irreversible complications, affecting the joints and other parts of the body such as the lungs, heart, eyes, and spine, which can lead to mobility problems. The unpredictable nature of RA, including flare-ups, can potentially cause long-term disability affecting the psychological state of patients.
Dr Cheah stressed the need for mental health support for patients and their families due to challenges like anxiety or depression. Support groups like the Arthritis Foundation Malaysia (AFM) provide a crucial network for sharing experiences and practical advice.
He also addressed the challenges in diagnosing RA due to the lack of certain tests, which makes the process more complex. SMC has developed a combination of approaches starting with a detailed patient history, followed by a physical examination and musculoskeletal ultrasound imaging to detect signs typical of RA.
In the early stages of RA, patients are usually administered anti-inflammatory drugs. To modify the progression of RA, disease-modifying antirheumatic drugs (DMARDs) are essential, which can be classified as conventional synthetic DMARDs or biologic DMARDs. Dr Cheah stated that patients diagnosed early often respond better to conventional synthetic DMARDs, whereas adjustments may be needed for those who do not respond well to treatment, including advanced therapies like biologic DMARDs and oral small molecules. These therapies target specific inflammatory molecules, offering improved efficacy and fewer side effects compared to traditional treatments.