World Reumaday is on October 12th. A perfect moment to reflect on rheumatoid arthritis (RA), the most common form of rheumatism that affects about one in a hundred people in the Netherlands. At the Leiden University Medical Center (LUMC), Dr. Annette van der Helm is researching a way to cure and prevent the disease.
What is rheumatoid arthritis?
Van der Helm: "Rheumatoid arthritis is an autoimmune disorder. That means that your immune system recognizes your own good body cells for hostile intruders and wants to work them out. With rheumatoid arthritis this is directed against your own joint clothing and you get inflamed joints. How it works exactly, we don't know yet. In the Netherlands, one in a hundred people suffer from it. "
Is RA the same as rheumatism?
"No, rheumatoid arthritis is a form of rheumatism. It is the most common form of inflammatory rheumatism. Rheumatoid arthritis is characterized by inflammation of the hand and foot joints. Other forms of rheumatism involve other joints or joint inflammation. "
Figures and facts about rheumatoid arthritis
- The disease often starts between forty and fifty years
- Two thirds of the patients are women, one third are men
- Heredity plays a minor role
- People with first-degree relatives with rheumatoid arthritis are twice as likely to get it, but in absolute numbers the chance remains small
What kind of complaints does it give?
"Patients often have swollen painful joints. The hands and feet in particular are painful and stiff and people suffer from fatigue. It is a chronic disease, which means that the disease does not spread."
"Until twenty years ago many patients with fused joints ended up in a wheelchair, now it hardly ever happens anymore." Annette van der Helm, researcher LUMC
"Over time, the inflamed joints may start to deform. Until twenty years ago, many patients with fused joints ended up in a wheelchair. At that time, we thought there was nothing to do about the disease."
But something can be done about it?
"Yes. In the last fifteen to twenty years you have hardly seen any patients with rheumatism in a wheelchair anymore. This is on the one hand because we have better medicines to better suppress inflammation, but also because we are more alert to complaints and can make the diagnosis earlier. In we believe that early diagnosis can be even more profitable. "
"It used to be thought that rheumatism only manifested when you could see on the outside that the joints were swollen. But now we know that the disease manifests itself earlier. People who come to the doctor with swollen and painful joints often already have a suffer from joint pain, stiffness and fatigue six months to a year before. Inflammations can also be seen six to twelve months in advance on an MRI. "
"Our hypothesis is that with a very early treatment start we can prevent complaints from becoming chronic. Compare it to weeds; you can combat that by mowing it above the ground, but it always comes back because you don't have the problem at the roots With our research we want to see if we can intervene earlier. The goal is shorter treatment, better functioning of the patient and less pain and fatigue. "
It used to be thought that rheumatism only manifested when you could see on the outside that the joints were swollen. Now we know that the disease manifests itself earlier. (Photo: 123RF)
What does that research look like?
"We first looked for people who were more likely to develop rheumatoid arthritis over time. Currently, half of the patients are receiving methotrexate treatment for a year and the other half are receiving a placebo, a fake pill."
"After that the patients will be followed without medication for another year to see if the improvements in the symptoms are permanent. It will take a while before we can complete the study and draw conclusions. But hopefully we will know within the next two years Lake."
What can we do ourselves if we suspect that we have rheumatoid arthritis?
"Unfortunately, the diagnosis can only be made when the inflammation is visible on the outside. But if before that time you suffer from morning stiffness and pain in hands and feet and buttoning a blouse or opening a juice or milk carton 's becomes more difficult in the morning, contact the doctor. "
"The doctor can assess whether a referral to the rheumatologist makes sense. Hopefully our research will also help to make the diagnosis earlier in the future."
Do you have good hope for the future?
"Certainly. We come a long way when it comes to rheumatism. There have been many developments in recent years that have dramatically improved the lives of rheumatism patients. I am proud that we can now cherish hope at all. That hope is real "I think it is honorable to contribute to the rheumatism examination with our research and I hope that in the long term rheumatoid arthritis can be completely prevented."
Prof. Annette van der Helm is a researcher at the LUMC. She is researching rheumatoid arthritis.