--- title: Rheumatoid Arthritis (RA) url: "https://www.yyhmedical.com/en/guide/autoimmune/disease-rheumatoid-arthritis" type: MedicalWebPage inLanguage: en-US --- # Rheumatoid Arthritis (RA) > Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that causes persistent inflammation in the joints. It commonly affects multiple joints in the hands, wrists, and feet, often in a relatively symmetric pattern. Without adequate control, ongoing inflammation can damage cartilage and bone, leading to joint deformity and loss of function. RA can also affect other parts of the body, including the lungs, eyes, skin, and blood. ## Overview RA is a chronic inflammatory disease caused by an abnormal immune response against the body’s own tissues, particularly the synovial lining of the joints. It most commonly affects the metacarpophalangeal, proximal interphalangeal, wrist, and foot joints, although the knees, ankles, shoulders, and elbows may also be involved. Pain, swelling, and morning stiffness are typical features. RA is a systemic disease and can also cause rheumatoid nodules, interstitial lung disease, eye inflammation, anemia, vasculitis, and other extra-articular manifestations. Modern RA care emphasizes early diagnosis, early treatment, and a treat-to-target approach in which disease activity is monitored regularly and therapy is adjusted until remission or low disease activity is achieved. ## Causes and Risk Factors The exact cause of RA is not fully understood. It is thought to result from an interaction between genetic susceptibility, abnormal immune responses, and environmental factors. Associated factors include family history, smoking, age and sex, obesity, and other environmental or immune-related influences. RA can cluster in families, but it is not inherited in a simple way. Having a relative with RA does not mean that another family member will necessarily develop the disease. Smoking is one of the best-established modifiable risk factors, particularly for some autoantibody-positive forms of RA. ## Signs and Symptoms RA symptoms vary from person to person. Common manifestations include: - Pain and swelling in multiple joints - Stiffness after waking or after prolonged inactivity - Involvement of the small joints of the hands, wrists, and feet - Similar joints affected on both sides of the body - Reduced joint movement - Fatigue, reduced appetite, or low-grade fever Morning stiffness is a characteristic symptom and often improves gradually with movement. If inflammation remains uncontrolled for a long time, structural joint damage and deformity may develop. However, severe deformities are less common when RA is diagnosed and treated effectively at an early stage. Some patients also develop rheumatoid nodules, lung disease, eye inflammation, anemia, or other systemic complications. ## Diagnosis There is no single test that can diagnose RA by itself. Doctors consider the pattern of joint involvement, swelling, duration of symptoms, inflammatory markers, autoantibodies, and imaging findings. Common tests include rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), C-reactive protein, erythrocyte sedimentation rate, complete blood count, and liver and kidney function tests. X-rays, musculoskeletal ultrasound, or MRI may also help assess inflammation and joint damage. RF and anti-CCP are important diagnostic markers, but a positive RF test alone does not establish a diagnosis. RF can be positive in other autoimmune diseases, chronic infections, and some healthy people. Some patients with RA are negative for both RF and anti-CCP. ## Treatment The goal of RA treatment is not simply to relieve pain but to suppress inflammation early enough to prevent irreversible joint damage. The 2025 EULAR recommendations state that DMARD treatment should begin as soon as RA is diagnosed and should aim for sustained remission or low disease activity. If there is insufficient improvement within about three months or the treatment target has not been reached by six months, therapy should generally be adjusted. **Disease-Modifying Antirheumatic Drugs **(DMARDs)**** Methotrexate remains a key initial treatment for many patients. Leflunomide or sulfasalazine may be considered when methotrexate cannot be used or tolerated. **Biologic DMARDs and Targeted Synthetic DMARDs** If conventional DMARD therapy does not achieve the treatment target, a biologic DMARD may be added. Biologic therapies include TNF inhibitors, IL-6 pathway inhibitors, abatacept, rituximab, and other agents. JAK inhibitors are targeted synthetic DMARDs and may also be considered for selected patients. However, treatment decisions should take into account individual risks such as cardiovascular disease, blood clots, serious infection, and malignancy. The 2025 EULAR recommendations specifically emphasize these safety considerations when JAK inhibitors are used. **Glucocorticoids and Analgesics** Nonsteroidal anti-inflammatory drugs can relieve pain and inflammation but do not prevent long-term joint damage and cannot replace DMARD therapy. Glucocorticoids may provide rapid control of inflammation and can be used for a short period when DMARD therapy is started or adjusted. They should be tapered and discontinued as quickly as clinically feasible to reduce long-term complications. **Treatment Goals** Modern RA care follows a treat-to-target strategy. The goals are to achieve and maintain remission or low disease activity, relieve pain and swelling, prevent structural joint damage, preserve physical function, and reduce systemic complications. Disease activity should be assessed regularly rather than judging treatment effectiveness only by how much the joints hurt. ## Content attribution (YMYL) - Author: - Medically reviewed by: - Last reviewed: - First published: > --- Original (HTML):https://www.yyhmedical.com/en/guide/autoimmune/disease-rheumatoid-arthritis This is a clean Markdown mirror for large language models; the original page is authoritative.